Individual provider Active NPI

Guy Thomas Young, MD

  • Anesthesiology Physician
  • Cordele, GA
National Provider Identifier
1124238878
Registry record updated Jan 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
060900 Issued in GA
Practice address
902 N. Seventh St.
Cordele, GA 31015
Phone
(229) 276-3100
Fax
(229) 271-4654
NPI assigned
May 23, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 0101239107 VA
Anesthesiology Physician 207L00000X 060900 GA Primary

Addresses

Primary practice location

902 N. Seventh St.
Cordele, GA 31015

Mailing address

PO Box 5007
Cordele, GA 31010-5007
Phone (229) 276-3100

Other identifiers 1

IdentifierTypeStateIssuer
406134136AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080630000206 GA Practitioner - Anesthesiology 3274605647 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Medical College of Georgia School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ams Southeast LLCGroup PAC ID 3870880792, 83 clinicians

Practice addresses (Care Compare)

902 N 7TH St
Cordele, GA 31015-3234
Phone (229) 276-3100

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0101239107VAMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Ams Southeast LLC Anesthesiology CurrentSince Feb 15, 2024 Accepting new patients
Crisp Regional Hospital Inc CurrentSince Jul 1, 2008 Accepting new patients
Crisp Regional Hospital, Inc CurrentSince Jul 1, 2008 Accepting new patients

Locations

2260 Wrightsboro Rd
Augusta, GA 30904
Phone (706) 481-7000

902 N 7th St
Ste N
Cordele, GA 31015

910 N 5th St
Cordele, GA 31015
Phone (229) 271-4652

902 N 7th St
Cordele, GA 31015
Phone (229) 276-3100

Interoperability endpoints

  • Direct secure messaging: guy.young@crispregional.gadirect.net

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611619200000",
    "number": "1124238878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5007",
            "city": "CORDELE",
            "state": "GA",
            "postal_code": "310105007",
            "telephone_number": "229-276-3100",
            "fax_number": "229-271-4654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "902 N. SEVENTH ST.",
            "city": "CORDELE",
            "state": "GA",
            "postal_code": "31015",
            "telephone_number": "229-276-3100",
            "fax_number": "229-271-4654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "GUY",
        "middle_name": "THOMAS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-23",
        "last_updated": "2021-01-26",
        "certification_date": "2021-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "VA",
            "license": "0101239107",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "GA",
            "license": "060900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "406134136A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cordele, GA

Sources for this page

Verify at the official NPI Registry.