Individual provider Active NPI

Nancy C. Young

  • Registered Nurse
  • Shiprock, NM
National Provider Identifier
1104467661
Registry record updated Oct 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
1619370 Issued in CO
Practice address
US Hwy 64 Old High School Rd
Shiprock, NM 87420-8742
Phone
(505) 368-5163
Fax
(505) 368-5502
NPI assigned
Oct 4, 2019
Last updated
Oct 4, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 1619370 CO Primary

Addresses

Primary practice location

US Hwy 64 Old High School Rd
Shiprock, NM 87420-8742

Mailing address

PO Box 1199
Shiprock, NM 87420-1199
Phone (505) 368-5163

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1619370COMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Central Consolidated School District CurrentSince Jul 2, 2023 Accepting new patients
Central Consolidated School District #22 PastSince Oct 6, 2019 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1570147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570147200000",
    "number": "1104467661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1199",
            "city": "SHIPROCK",
            "state": "NM",
            "postal_code": "874201199",
            "telephone_number": "505-368-5163",
            "fax_number": "505-368-5502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "US HWY 64 OLD HIGH SCHOOL RD",
            "city": "SHIPROCK",
            "state": "NM",
            "postal_code": "874208742",
            "telephone_number": "505-368-5163",
            "fax_number": "505-368-5502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "NANCY",
        "middle_name": "C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-04",
        "last_updated": "2019-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CO",
            "license": "1619370",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shiprock, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 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.

Verify at the official NPI Registry.