Kelly Ray Young, CRNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

1-117362 Issued in AL

Practice address

2893 Huntsville Hwy Ste B
Fayetteville, TN 37334-6681

Phone

(931) 297-1050

Fax

(931) 914-1257

NPI assigned

Sep 20, 2011

Last updated

Aug 19, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Promed Preferred TN 2 PLLCGroup PAC ID 6507341542, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Promed Preferred TN 2 PLLC

  • Family Medicine Physician
  • Fayetteville, TN
  • NPI 1184576548
  Medicare reassignment Care Compare group NPD
• Southern Family Medicine LLC

  • Family Medicine Physician
  • Fayetteville, TN
  • NPI 1992664965
  NPD (past)
• Sleep & Pulmonary Care Center, P.C.

  • Pulmonary Disease Physician
  • Decatur, AL
  • NPI 1346406469
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1316476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787097600000",
    "number": "1083996714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2893 HUNTSVILLE HWY STE B",
            "city": "FAYETTEVILLE",
            "state": "TN",
            "postal_code": "373346681",
            "telephone_number": "931-297-1050",
            "fax_number": "931-914-1257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2893 HUNTSVILLE HWY STE B",
            "city": "FAYETTEVILLE",
            "state": "TN",
            "postal_code": "373346681",
            "telephone_number": "931-297-1050",
            "fax_number": "931-914-1257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "KELLY",
        "middle_name": "RAY",
        "name_prefix": "Ms.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-20",
        "last_updated": "2026-08-19",
        "certification_date": "2026-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-117362",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William Coy Womble, O.D.
• Avery Cameron Woodall, PHARM.D.
• Connie Maloe Work, LCSW
• Bryan Wesley Wunner
• Amber Michele Hardy Young, PT, DPT
• Matthew Zinn

• Family Nurse Practitioner in Fayetteville, TN
• Providers in Fayetteville, TN by specialty
• Family Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.