Sandra Denise Thebaud-Young, APRN-BC

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

26NJ00129300 Issued in NJ

Practice address

254 Easton Avenue
New Brunswick
New Brunswick, NJ 08901

Phone

(908) 392-1948

Fax

(973) 337-2045

NPI assigned

Mar 22, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: sandra.thebaud-young.1@24114.direct.athenahealth.com

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.

• NP Associates PA

  • Skilled Nursing Facility
  • Parsippany, NJ
  • NPI 1679736912
  NPD (past)
• NP Care of NJ, LLC

  • Nurse Practitioner
  • Brick, NJ
  • NPI 1245289842
  NPD (past)

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1256515200000",
    "number": "1114043064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "239 40TH ST",
            "address_2": "IRVINGTON",
            "city": "IRVINGTON",
            "state": "NJ",
            "postal_code": "071111100",
            "telephone_number": "973-371-5563",
            "fax_number": "973-337-2045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "254 EASTON AVENUE",
            "address_2": "NEW BRUNSWICK",
            "city": "NEW BRUNSWICK",
            "state": "NJ",
            "postal_code": "08901",
            "telephone_number": "908-392-1948",
            "fax_number": "973-337-2045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THEBAUD-YOUNG",
        "first_name": "SANDRA",
        "middle_name": "DENISE",
        "name_prefix": "Mrs.",
        "credential": "APRN-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-22",
        "last_updated": "2009-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NJ",
            "license": "26NJ00129300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0147320",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "112818VGD",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• The Cancer Institute of New Jersey
• The Greater Brunswick Charter School
• The RX Wig
• The Urban Health Collaborative
• Tiong Gwan The, MBBS, DCH
• Dylan Robert Theiss
• Lisa Then, LAC, R-DMT
• Arunachalam Thenappan, MD
• Christina Theodorou Ross, MD
• Perumal Thiyagarajan, M.D.

• Adult Health Nurse Practitioner in New Brunswick, NJ
• Providers in New Brunswick, NJ by specialty
• Adult Health Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2009; 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.