NPIMap

Individual provider Active NPI

Shelby Madalyn Young, DNP, FNP-C

  • Family Nurse Practitioner
  • Louisville, KY
National Provider Identifier
1215654785
Registry record updated Mar 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3018495 Issued in KY
Practice address
3920 Dutchmans LN Ste 309
Louisville, KY 40207-4702
Phone
(502) 588-4740
Fax
(502) 588-9537
NPI assigned
Oct 25, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 3018495 KY Primary

Addresses

Primary practice location

3920 Dutchmans LN Ste 309
Louisville, KY 40207-4702

Mailing address

PO Box 909
Louisville, KY 40201-0909
Phone (502) 588-0328

Other identifiers 2

IdentifierTypeStateIssuer
300071455MedicaidIN
7100863720MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221110001473 KY Practitioner - Nurse Practitioner 6305213943 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

3920 Dutchmans LN
Suite 309
Louisville, KY 40207-4702
Phone (502) 259-6062

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
78.96 of 100Reported as group
Quality
56.12
Promoting interoperability
100
Improvement activities
40
Cost
73.73

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Kiosk Medicine Kentucky LLC Family CurrentSince Oct 14, 2022 Accepting new patients
University of Louisville Phyisicians, Inc. CurrentSince Feb 20, 2023 Accepting new patients
University of Louisville Physicians, Inc. CurrentSince Feb 20, 2023 Accepting new patients
University of Louisville Physicians, Inc. Nurse Practitioner Current Accepting new patients

Locations

7752 Solution Ctr
Chicago, IL 60677

3920 Dutchmans Ln
Louisville, KY 40207
Phone (502) 259-6000

3039 Breckenridge Ln
Louisville, KY 40220
Phone (502) 451-4555

3920 Dutchmans Ln
Ste 309
Louisville, KY 40207
Phone (502) 896-2319

571 S Floyd St
Louisville, KY 40202
Phone (502) 561-2700

234 Eastbrooke Pkwy
Mt Washington, KY 40047
Phone (502) 538-1241

Interoperability endpoints

  • Direct secure messaging: shelby.young@krogerhealth.eclinicaldirectplus.com
  • Direct secure messaging: syoung35071@uoflhealth-dm.org

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.

Hospital & facility affiliations 39

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 39

NPI Registry JSON

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

{
    "created_epoch": "1666656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677628800000",
    "number": "1215654785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 909",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402010909",
            "telephone_number": "502-588-0328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3920 DUTCHMANS LN STE 309",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402074702",
            "telephone_number": "502-588-4740",
            "fax_number": "502-588-9537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "SHELBY",
        "middle_name": "MADALYN",
        "credential": "DNP, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-25",
        "last_updated": "2023-03-01",
        "certification_date": "2023-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3018495",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300071455",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100863720",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.