Individual provider Active NPI

Jason R Young, CNP

  • Family Nurse Practitioner
  • Bella Vista, AR
National Provider Identifier
1205224870
Registry record updated Dec 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
A004285 Issued in AR
Practice address
1 Mercy Way Ste 20
Bella Vista, AR 72714-3000
Phone
(479) 802-5555
Fax
(479) 876-2829
NPI assigned
Jan 5, 2015
Last updated
Dec 7, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 7, 2022

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 ATP000731 AR
Family Nurse Practitioner 363LF0000X A004285 AR Primary

Addresses

Primary practice location

1 Mercy Way Ste 20
Bella Vista, AR 72714-3000

Mailing address

1 Mercy Way Ste 20
Bella Vista, AR 72714-3000
Phone (479) 802-5555

Other practice location 1

643 E 3rd St
Gentry, AR 72734-8258
Phone (479) 736-2213

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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
I20150312001745 AR Practitioner - Nurse Practitioner 7810213717 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1 Mercy Way
Bella Vista, AR 72714-3000
Phone (479) 802-5555

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ATP000731ARMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health Northwest Arkansas Communities CurrentSince Dec 19, 2022 Accepting new patients
Washington Regional Medical System CurrentSince Dec 1, 2016 Accepting new patients
Washington Regional Medical System Current Accepting new patients
Washington Regional Medical System CurrentSince Dec 1, 2016 Accepting new patients
Mercy Health Northwest Arkansas Communities CurrentSince Dec 19, 2022 Accepting new patients
Washington Regional Medical System Past Accepting new patients

Locations

1 Mercy Way
Bella Vista, AR 72714
Phone (479) 802-5555

1 Mercy Way
Ste 20
Bella Vista, AR 72714
Phone (479) 802-5555

3101 SE 14th St
Bentonville, AR 72712
Phone (479) 631-2100

3017 N Bob Younkin Dr
Ste 102
Fayetteville, AR 72703
Phone (479) 463-4325

3215 N Northhills Blvd
Fayetteville, AR 72703
Phone (479) 463-1000

451 S Holly St
Siloam Springs, AR 72761
Phone (479) 524-3141

Organizations & group practices 6

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": "1420416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670371200000",
    "number": "1205224870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MERCY WAY STE 20",
            "city": "BELLA VISTA",
            "state": "AR",
            "postal_code": "727143000",
            "telephone_number": "479-802-5555",
            "fax_number": "479-876-2829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MERCY WAY STE 20",
            "city": "BELLA VISTA",
            "state": "AR",
            "postal_code": "727143000",
            "telephone_number": "479-802-5555",
            "fax_number": "479-876-2829"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "643 E 3rd St",
            "address_purpose": "LOCATION",
            "city": "Gentry",
            "state": "AR",
            "postal_code": "727348258",
            "country_code": "US",
            "telephone_number": "479-736-2213",
            "fax_number": "479-736-2105",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "JASON",
        "middle_name": "R",
        "credential": "CNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-01-05",
        "last_updated": "2022-12-07",
        "certification_date": "2022-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "ATP000731",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "A004285",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bella Vista, AR

Sources for this page

Verify at the official NPI Registry.