Individual provider Active NPI

Donald G Nunlist Young, M.D.

  • Family Medicine Physician
  • Cincinnati, OH
National Provider Identifier
1104879873
Registry record updated Oct 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35039349 Issued in OH
Practice address
3805 Edwards Rd Ste 360
Cincinnati, OH 45209-1934
Phone
(513) 871-7848
Fax
(513) 871-3278
NPI assigned
May 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 35039349 OH Primary

Addresses

Primary practice location

3805 Edwards Rd Ste 360
Cincinnati, OH 45209-1934

Mailing address

3805 Edwards Rd Ste 360
Cincinnati, OH 45209-1934
Phone (513) 871-7848

Other identifiers 2

IdentifierTypeStateIssuer
0317302MedicaidOH
64765035MedicaidKY

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dnunlistyoung1687@direct.thechristhospital.com Direct

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
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
The Christ Hospital Medical Associates, III CurrentSince Apr 25, 2022 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

3805 Edwards Rd
Ste 360
Cincinnati, OH 45209
Phone (513) 321-0833

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.

NPI Registry JSON

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603238400000",
    "number": "1104879873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3805 EDWARDS RD STE 360",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452091934",
            "telephone_number": "513-871-7848",
            "fax_number": "513-871-3278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3805 EDWARDS RD STE 360",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452091934",
            "telephone_number": "513-871-7848",
            "fax_number": "513-871-3278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NUNLIST YOUNG",
        "first_name": "DONALD",
        "middle_name": "G",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-17",
        "last_updated": "2020-10-21",
        "certification_date": "2020-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35039349",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0317302",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64765035",
            "state": "KY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dnunlistyoung1687@direct.thechristhospital.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3805 Edwards Rd Ste 360",
            "city": "Cincinnati",
            "state": "OH",
            "country_code": "US",
            "postal_code": "452091934",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2020; 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.