Active NPI
Kelly Thomas Young, NP
- Nurse Practitioner
- Burnsville, MN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 2326
- Practice address
- 14000 Fairview Dr
Burnsville, MN 55337-4571 - Phone
- (952) 993-8700
- Fax
- (952) 993-8516
- NPI assigned
- May 12, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | R 168856-0 | MN | |
| Family Nurse Practitioner | 363LF0000X | CNP2326 | MN | |
| Nurse Practitioner | 363L00000X | 2326 | MN | Primary |
Addresses
Primary practice location
14000 Fairview Dr
Burnsville, MN 55337-4571
Mailing address
8170 33Rd Ave S
Ms 21110Q
Bloomington, MN 55425-4516
Other practice location 1
1580 Beam Ave
Maplewood, MN 55109-1127
Phone (651) 255-8480
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1415 Saint Francis Ave
Shakopee, MN 55379-3374
Phone (952) 993-7750
15350 English Ave
Apple Valley, MN 55124-6252
Phone (952) 431-8500
1654 Diffley Rd
Suite 100
Eagan, MN 55122-2237
Phone (651) 641-3900
1885 Plaza Dr
Eagan, MN 55122-2979
Phone (952) 993-4001
5320 Hyland Greens Dr
Bloomington, MN 55437-3934
Phone (952) 993-2400
640 Jackson St
Saint Paul, MN 55101-2502
Phone (651) 221-3456
8325 Seasons Pkwy
Woodbury, MN 55125-4402
Phone (651) 702-5868
8450 Seasons Pkwy
Woodbury, MN 55125-4402
Phone (651) 702-5300
8600 Nicollet Ave
Bloomington, MN 55420-2824
Phone (952) 884-1148
Hospital & facility affiliations
- St Francis Regional Medical Center
- Regions Hospital
- Park Nicollet Methodist Hospital
- Abbott Northwestern Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CNP2326 | MN | MD | Family Nurse Practitioner |
| R 168856-0 | MN | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Park Nicollet Clinic | Current | Accepting new patients | |
| Group Health, Inc. | Current | Accepting new patients | |
| Minnesota Oncology Hematology, PA | Past | Accepting new patients | |
| Minnesota Oncology Hematology, PA | Nurse Practitioner | Past | Accepting new patients |
| Minnesota Oncology Hematology, PA | Family | Past | Accepting new patients |
Locations
14000 Fairview Dr
Burnsville, MN 55337
Phone (952) 993-8608
8170 33rd Ave S
#21110Q
Minneapolis, MN 55425
Phone (952) 883-5375
8600 Nicollet Ave S
Minneapolis, MN 55420
Phone (952) 887-6600
2220 Riverside Ave
Minneapolis, MN 55454
Phone (612) 371-1600
5320 Hyland Greens Dr
Minneapolis, MN 55437
Phone (952) 993-2400
640 Jackson St
Saint Paul, MN 55101
Phone (651) 221-2164
Organizations & group practices 5
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.
-
- Multi-Specialty Clinic/Center
- Minneapolis, MN
- NPI 1710924683
-
- Family Medicine Physician
- St Louis Park, MN
- NPI 1780621904
-
- Hematology & Oncology Physician
- Saint Paul, MN
- NPI 1528035995
Family
-
- Radiation Oncology Physician
- Saint Paul, MN
- NPI 1598305427
-
- Hematology & Oncology Physician
- Saint Paul, MN
- NPI 1609911205
Nurse Practitioner
Hospital & facility affiliations 38
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Obesity Medicine (Family Medicine) Physician
- Minneapolis, MN
- NPI 1154684835
Hospital
-
- Physical Medicine & Rehabilitation Physician
- Minneapolis, MN
- NPI 1275577215
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1399852800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1630022400000",
"number": "1154732360",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8170 33RD AVE S",
"address_2": "MS 21110Q",
"city": "BLOOMINGTON",
"state": "MN",
"postal_code": "554254516"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14000 FAIRVIEW DR",
"city": "BURNSVILLE",
"state": "MN",
"postal_code": "553374571",
"telephone_number": "952-993-8700",
"fax_number": "952-993-8516"
}
],
"practiceLocations": [
{
"address_1": "1580 Beam Ave",
"address_purpose": "LOCATION",
"city": "Maplewood",
"state": "MN",
"postal_code": "551091127",
"country_code": "US",
"telephone_number": "651-255-8480",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "YOUNG",
"first_name": "KELLY",
"middle_name": "THOMAS",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-05-12",
"last_updated": "2021-08-27",
"certification_date": "2021-08-27",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "MN",
"license": "R 168856-0",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "MN",
"license": "CNP2326",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "MN",
"license": "2326",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Burnsville, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.