Individual provider Active NPI

Marcus D Young

  • Non-emergency Medical Transport (VAN)
  • Canton, MS
National Provider Identifier
1114270337
Registry record updated May 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-emergency Medical Transport (VAN)Taxonomy code 343900000X
Practice address
242 W North St
Canton, MS 39046-3723
Phone
(769) 233-3661
NPI assigned
Oct 25, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 9, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Non-emergency Medical Transport (VAN) 343900000X MS Primary
Bus 347B00000X 801592792 MS

Addresses

Primary practice location

242 W North St
Canton, MS 39046-3723

Mailing address

242 W North St
Canton, MS 39046-3723
Phone (769) 233-3661

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
801592792MSMDBus

NPI Registry JSON

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

{
    "created_epoch": "1351123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683590400000",
    "number": "1114270337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "242 W NORTH ST",
            "city": "CANTON",
            "state": "MS",
            "postal_code": "390463723",
            "telephone_number": "769-233-3661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "242 W NORTH ST",
            "city": "CANTON",
            "state": "MS",
            "postal_code": "390463723",
            "telephone_number": "769-233-3661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "MARCUS",
        "middle_name": "D",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-10-25",
        "last_updated": "2023-05-09",
        "certification_date": "2023-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "MS",
            "license": null,
            "primary": true
        },
        {
            "code": "347B00000X",
            "taxonomy_group": "",
            "desc": "Bus",
            "state": "MS",
            "license": "801592792",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2023; 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.