NPIMap

Individual provider Active NPI

Jonathan Joel Young, PA-C

  • Physician Assistant
  • Mt Pleasant, SC
National Provider Identifier
1093026536
Registry record updated Mar 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1686 Issued in SC
Practice address
1101 Bowman Rd
Mt Pleasant, SC 29464-3213
Phone
(843) 552-4240
Fax
(843) 552-4121
NPI assigned
Jun 30, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 15, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5601005796 MI
Physician Assistant 363A00000X 1686 SC Primary

Addresses

Primary practice location

1101 Bowman Rd
Mt Pleasant, SC 29464-3213

Mailing address

PO Box 50520
Summerville, SC 29485-0520
Phone (843) 552-4240

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, SC2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20101101001294 MI Practitioner - Physician Assistant 8123212370 Reassigns benefits to 1 organization
I20140908000871 SC Practitioner - Physician Assistant 8123212370 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Wayne State University School of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cora South Carolina LLCGroup PAC ID 3173766334, shared by 6 NPIs, 220 clinicians

Practice addresses (Care Compare)

18 Professional Village Cir
Beaufort, SC 29907-1570
Phone (843) 986-9670

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Roper St. Francis Mount Pleasant Hospital CurrentSince Sep 9, 2014 Accepting new patients
Roper Hospital Inc CurrentSince Jun 16, 2014 Accepting new patients
Bon Secours St. Francis Xavier Hospital, Inc. CurrentSince Sep 1, 2020 Accepting new patients
Roper Hospital Inc. CurrentSince Jun 16, 2014 Accepting new patients
Bon Secours St Francis Xavier Hospital, Inc. CurrentSince Sep 1, 2020 Accepting new patients
Roper St. Francis Mount Pleasant Hospital CurrentSince Sep 9, 2014 Accepting new patients

Locations

2095 Henry Tecklenburg Dr
Charleston, SC 29414
Phone (843) 402-1037

316 Calhoun St
Charleston, SC 29401
Phone (843) 724-2000

3500 N Highway 17
Mt Pleasant, SC 29466
Phone (843) 606-7000

Interoperability endpoints

  • Direct secure messaging: jyoung3421515@direct.trinity-health.org
  • Direct secure messaging: jyoung1158444@direct.hfhs.org

Organizations & group practices 10

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

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1277856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363305600000",
    "number": "1093026536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 50520",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294850520",
            "telephone_number": "843-552-4240",
            "fax_number": "843-552-4121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 BOWMAN RD",
            "city": "MT PLEASANT",
            "state": "SC",
            "postal_code": "294643213",
            "telephone_number": "843-552-4240",
            "fax_number": "843-552-4121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "JONATHAN",
        "middle_name": "JOEL",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-06-30",
        "last_updated": "2013-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601005796",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "1686",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mt Pleasant, SC

Sources for this page

Verify at the official NPI Registry.