Active NPI
Andrew Thomas Young, AUD
- Audiologist
- Omaha, NE
National Provider Identifier
1093079808
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- 305
- Practice address
- 13336 Industrial Rd Ste 105
Omaha, NE 68137 - Phone
- (402) 330-3211
- Fax
- (402) 330-5970
- NPI assigned
- Jun 26, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Audiologist | 231H00000X | 201209713 | MO | |
| Audiologist | 231H00000X | 305 | NE | Primary |
Addresses
Primary practice location
13336 Industrial Rd Ste 105
Omaha, NE 68137
Mailing address
13336 Industrial Rd Ste 105
Omaha, NE 68137-1124
Phone (402) 330-3211
Other practice location 1
4880 NE Goodview Cir
Lees Summit, MO 64064-1996
Phone (816) 478-4200
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 305 | NE | MD | Occupational Therapy Assistant |
| 201209713 | MO | MD | Audiologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ascentist Physicians Group, LLC | Audiologist | Past | Accepting new patients |
| Makovicka Harms Group PC | Past | Accepting new patients |
Interoperability endpoints
- https://api.platform.athenahealth.com/24878/brand/1/csg/1/fhir/r4
Organizations & group practices 2
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.
-
dba Ascentist Healthcare
- Otolaryngology Physician
- Lee's Summit, MO
- NPI 1649206319
Audiologist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1340668800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1562630400000",
"number": "1093079808",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13336 INDUSTRIAL RD STE 105",
"city": "OMAHA",
"state": "NE",
"postal_code": "681371124",
"telephone_number": "402-330-3211",
"fax_number": "402-330-5970"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13336 INDUSTRIAL RD STE 105",
"city": "OMAHA",
"state": "NE",
"postal_code": "68137",
"telephone_number": "402-330-3211",
"fax_number": "402-330-5970"
}
],
"practiceLocations": [
{
"address_1": "4880 NE Goodview Cir",
"address_purpose": "LOCATION",
"city": "Lees Summit",
"state": "MO",
"postal_code": "640641996",
"country_code": "US",
"telephone_number": "816-478-4200",
"fax_number": "816-478-0507",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "YOUNG",
"first_name": "ANDREW",
"middle_name": "THOMAS",
"credential": "AUD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-06-26",
"last_updated": "2019-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "MO",
"license": "201209713",
"primary": false
},
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "NE",
"license": "305",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Omaha, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.