Organization Active NPI

Scott a. Young M.D., PSC

  • Internal Medicine Physician
  • Louisville, KY
National Provider Identifier
1114935319
Registry record updated Jun 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
32052 Issued in KY
Legal business name
SCOTT A. YOUNG M.D., PSC
Practice address
12010 Shelbyville Rd
Suite 300
Louisville, KY 40243-1054
Phone
(502) 244-9355
Fax
(502) 244-9577
NPI assigned
Aug 3, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2024

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

Authorized official

Name
Dr. Scott A. Young, M.D.NPI 1104018977
Title
President
Phone
(502) 244-9355

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 32052 KY Primary

Addresses

Primary practice location

12010 Shelbyville Rd
Suite 300
Louisville, KY 40243-1054

Mailing address

PO Box 436256
Louisville, KY 40253-6256
Phone (502) 244-9355

Other identifiers 4

IdentifierTypeStateIssuer
G78602OtherKYUPIN
5459438OtherAETNA PROVIDER ID
P00202026OtherKYRAILROAD MEDICARE ID
000000337192OtherANTHEM PROVIDER ID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041018000096 KY Part B Supplier - Clinic/Group Practice 9335109016 Receives reassigned benefits from 1 practitioner
Practice locations: Louisville, KY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718582400000",
    "number": "1114935319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 436256",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402536256",
            "telephone_number": "502-244-9355",
            "fax_number": "502-244-9577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12010 SHELBYVILLE RD",
            "address_2": "SUITE 300",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402431054",
            "telephone_number": "502-244-9355",
            "fax_number": "502-244-9577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCOTT A. YOUNG M.D., PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-03",
        "last_updated": "2024-06-17",
        "certification_date": "2024-06-17",
        "status": "A",
        "authorized_official_last_name": "YOUNG",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "502-244-9355",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "32052",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UPIN",
            "identifier": "G78602",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PROVIDER ID",
            "identifier": "5459438",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE ID",
            "identifier": "P00202026",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PROVIDER ID",
            "identifier": "000000337192",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.