Individual provider Active NPI

Regina M Young, N.P.

  • Gerontology Nurse Practitioner
  • Corinth, MS
National Provider Identifier
1124298849
Registry record updated Feb 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
R803797 Issued in MS
Practice address
601 Foote St
Corinth, MS 38834-4834
Phone
(662) 287-4424
Fax
(662) 287-2070
NPI assigned
Mar 10, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X R803797 MS Primary

Addresses

Primary practice location

601 Foote St
Corinth, MS 38834-4834

Mailing address

PO Box 839
Corinth, MS 38835-0839
Phone (662) 286-9883

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS, TN2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20080606000196 MS Practitioner - Nurse Practitioner 5193895845 Reassigns benefits to 2 organizations
I20200930000487 TN Practitioner - Nurse Practitioner 5193895845 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Segue Health of Mississippi LLCGroup PAC ID 2769757897, 23 clinicians
Segue Health Partners LLCGroup PAC ID 5496020521, 29 clinicians

Practice addresses (Care Compare)

232 Market St
Flowood, MS 39232-3339
Phone 8885512538101

765 Woodland Trace LN
Cordova, TN 38018-6609
Phone (901) 626-3515

Merit-based Incentive Payment System (MIPS)

Final score
25.42 of 100Reported as individual
Quality
0
Promoting interoperability
0
Improvement activities
0
Cost
84.73

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R803797MSMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Signify Health Medical Associates, PLLC CurrentSince Jan 6, 2023 Accepting new patients
Signify Health, LLC CurrentSince Jan 13, 2023 Accepting new patients
Segue Health Partners LLC CurrentSince Sep 1, 2020 Accepting new patients

Locations

232 Market St
Jackson, MS 39232
Phone (588) 498-6767

460 Briarwood Dr
Ste 400
Jackson, MS 39206
Phone (601) 203-1016

300 Montvue Rd
Knoxville, TN 37919
Phone (818) 613-6769

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

4055 Valley View Ln
Ste 700
Dallas, TX 75244
Phone (469) 466-7424

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1205107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329264000000",
    "number": "1124298849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 839",
            "city": "CORINTH",
            "state": "MS",
            "postal_code": "388350839",
            "telephone_number": "662-286-9883",
            "fax_number": "662-284-9836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 FOOTE ST",
            "city": "CORINTH",
            "state": "MS",
            "postal_code": "388344834",
            "telephone_number": "662-287-4424",
            "fax_number": "662-287-2070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "REGINA",
        "middle_name": "M",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-10",
        "last_updated": "2012-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MS",
            "license": "R803797",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corinth, MS

Sources for this page

Verify at the official NPI Registry.