Individual provider Active NPI

Christian Casey Young, FNP

  • Family Nurse Practitioner
  • Anderson, CA
National Provider Identifier
1154659431
Registry record updated Jul 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95010353 Issued in CA
Practice address
2830 East St
Anderson, CA 96007-3408
Phone
(530) 365-2545
Fax
(530) 365-3871
NPI assigned
Nov 25, 2009
Last updated
Jul 25, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 25, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95010353 CA Primary
Registered Nurse 163W00000X 660294 CA

Addresses

Primary practice location

2830 East St
Anderson, CA 96007-3408

Mailing address

PO Box 1743
Shasta Lake, CA 96019-1743
Phone (530) 524-6045

Other names 1

  • Christian Casey Boge Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20220303002003 CA Practitioner - Nurse Practitioner 9830484153 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mountain Communities Healthcare DistrictGroup PAC ID 9133227135, shared by 4 NPIs, 34 clinicians

Practice addresses (Care Compare)

PO Box
Weaverville, CA 96093-1229

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95010353CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Shasta Regional Medical Group Inc CurrentSince Jun 7, 2023 Accepting new patients
Shasta Regional Medical Group, Inc CurrentSince Jun 7, 2023 Accepting new patients
Orna Gil MD Inc Current Accepting new patients
Mountain Communities Healthcare Dist Past Accepting new patients
Ronald L. Renard MD, Inc. PastSince Dec 17, 2021 Accepting new patients
Sierra Nevada Management Services PastSince Dec 17, 2021 Accepting new patients
Mountain Communities Healthcare District Past Accepting new patients
Shasta Regional Medical Group Inc Past Accepting new patients

Locations

2830 East St
Anderson, CA 96007
Phone (530) 365-2545

1801 W Olympic Blvd
#1640
Pasadena, CA 91199

1355 East St
Ste 200
Redding, CA 96001
Phone (530) 229-2940

Interoperability endpoints

  • Direct secure messaging: christian.youngnp.d1.p3@direct.smmg.nextgenshare.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/ABEFCA

Organizations & group practices 8

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": "1259107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690243200000",
    "number": "1154659431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1743",
            "city": "SHASTA LAKE",
            "state": "CA",
            "postal_code": "960191743",
            "telephone_number": "530-524-6045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2830 EAST ST",
            "city": "ANDERSON",
            "state": "CA",
            "postal_code": "960073408",
            "telephone_number": "530-365-2545",
            "fax_number": "530-365-3871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "CHRISTIAN",
        "middle_name": "CASEY",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-11-25",
        "last_updated": "2023-07-25",
        "certification_date": "2023-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95010353",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "660294",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHRISTIAN",
            "last_name": "BOGE",
            "middle_name": "CASEY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Anderson, CA

Sources for this page

Verify at the official NPI Registry.