Active NPI
Tyler Young
- Family Nurse Practitioner
- Austin, TX
National Provider Identifier
1215647185
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 1096217
- Practice address
- 3901 Medical Pkwy Ste 100
Austin, TX 78756-4022 - Phone
- (512) 343-9355
- NPI assigned
- Dec 1, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 1096217 | TX | Primary |
Addresses
Primary practice location
3901 Medical Pkwy Ste 100
Austin, TX 78756-4022
Mailing address
429 Stacey Ann Cove
Dripping Springs, TX 78620
Phone (512) 657-2212
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1096217 | TX | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1669852800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1669852800000",
"number": "1215647185",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "429 STACEY ANN COVE",
"city": "DRIPPING SPRINGS",
"state": "TX",
"postal_code": "78620",
"telephone_number": "512-657-2212"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3901 MEDICAL PKWY STE 100",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787564022",
"telephone_number": "512-343-9355"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YOUNG",
"first_name": "TYLER",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-12-01",
"last_updated": "2022-12-01",
"certification_date": "2022-11-27",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "TX",
"license": "1096217",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Austin, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.