Individual provider Active NPI

Maegan N Young, ACNPC-AG

  • Acute Care Nurse Practitioner
  • Shreveport, LA
National Provider Identifier
1104502624
Registry record updated May 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
229632 Issued in LA
Practice address
2551 Greenwood Rd Ste 230
Shreveport, LA 71103-3985
Phone
(318) 212-8177
NPI assigned
Jun 27, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 229632 LA Primary

Addresses

Primary practice location

2551 Greenwood Rd Ste 230
Shreveport, LA 71103-3985

Mailing address

334 Levin Lane
Shreveport, LA 71105
Phone (318) 470-9339

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240403002420 LA Practitioner - Nurse Practitioner 3476991902 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
WK Vascular SurgeryGroup PAC ID 3971976986, 2 clinicians

Practice addresses (Care Compare)

2551 Greenwood Rd
Suite 230
Shreveport, LA 71103-3985
Phone (318) 212-8177

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
229632LAMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
WK Vascular Surgery CurrentSince May 13, 2024 Accepting new patients
Willis Knighton Medical Center, Inc. PastSince Feb 29, 2024 Accepting new patients

Locations

2551 Greenwood Rd
Ste 230
Shreveport, LA 71103
Phone (318) 212-8070

1202 Louisiana Ave
Shreveport, LA 71101
Phone (318) 212-8946

Interoperability endpoints

  • Direct secure messaging: myoung3@direct.wkhs.com

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.

Hospital & facility affiliations 4

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": "1687824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715558400000",
    "number": "1104502624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "334 LEVIN LANE",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "71105",
            "telephone_number": "318-470-9339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2551 GREENWOOD RD STE 230",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711033985",
            "telephone_number": "318-212-8177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "MAEGAN",
        "middle_name": "N",
        "name_prefix": "Ms.",
        "credential": "ACNPC-AG",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-27",
        "last_updated": "2024-05-13",
        "certification_date": "2024-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "LA",
            "license": "229632",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

Verify at the official NPI Registry.