Active NPI
Laura P Young, MD
- Cardiovascular Disease Physician
- Oxford, MS
National Provider Identifier
1104919513
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cardiovascular Disease Physician
- License
- 14981
- Practice address
- 2301 S Lamar Blvd
Oxford, MS 38655-5373 - Phone
- (662) 232-8568
- Fax
- (662) 513-1450
- NPI assigned
- Sep 30, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cardiovascular Disease Physician | 207RC0000X | 14981 | MS | Primary |
Addresses
Primary practice location
2301 S Lamar Blvd
Oxford, MS 38655-5373
Mailing address
2301 S Lamar Blvd
Oxford, MS 38655-5373
Phone (662) 232-8568
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 36-4373044 | Other | MS | EMPLOYER ID # |
| 116108 | Medicaid | MS |
Other names 1
- Laura P Fowlkes
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
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14981 | MS | MD | Cardiovascular Disease Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159574400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1274832000000",
"number": "1104919513",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2301 S LAMAR BLVD",
"city": "OXFORD",
"state": "MS",
"postal_code": "386555373",
"telephone_number": "662-232-8568",
"fax_number": "662-513-1450"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2301 S LAMAR BLVD",
"city": "OXFORD",
"state": "MS",
"postal_code": "386555373",
"telephone_number": "662-232-8568",
"fax_number": "662-513-1450"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YOUNG",
"first_name": "LAURA",
"middle_name": "P",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-09-30",
"last_updated": "2010-05-26",
"status": "A"
},
"taxonomies": [
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "MS",
"license": "14981",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EMPLOYER ID #",
"identifier": "36-4373044",
"state": "MS"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "116108",
"state": "MS"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "LAURA",
"last_name": "FOWLKES",
"middle_name": "P",
"credential": "MD",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Oxford, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.