NPIMap

Individual provider Active NPI

Roderick Allen Young, M.D.

  • Occupational Medicine Physician
  • Logan, WV
National Provider Identifier
1235295072
Registry record updated Apr 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Medicine PhysicianTaxonomy code 2083X0100X
License
18830 Issued in WV
Practice address
60 Hospital Dr
Logan, WV 25601-3452
Phone
(304) 831-1335
NPI assigned
Dec 28, 2006
Last updated
Apr 8, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 8, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 18830 WV
Occupational Medicine Physician 2083X0100X 18830 WV Primary

Addresses

Primary practice location

60 Hospital Dr
Logan, WV 25601-3452

Mailing address

PO Box 4190
Barboursville, WV 25504-4190
Phone (304) 399-4405

Other practice location 1

3012 Champion Dr
Barboursville, WV 25504-9343
Phone (304) 736-8764 ext. 102

Other practice location 2

2827 5th Ave
Huntington, WV 25702-1435
Phone (304) 399-7182

Other practice location 3

5430 MacCorkle Ave SE
Charleston, WV 25304-2224
Phone (304) 925-3627

Other practice location 4

2827 5th Ave
Huntington, WV 25702-1435
Phone (304) 399-7182

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address roderick.young@smmm.cernerdirect.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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
I20150121001717 WV Practitioner - Family Practice 0840514881 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Logan General Hospital LLCGroup PAC ID 9537078977, 27 clinicians

Practice addresses (Care Compare)

77 Hospital Dr
FL 4
Logan, WV 25601-3451
Phone (304) 831-1663

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
18830WVMDOccupational Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Mary's Medical Management, LLC CurrentSince Jan 1, 2015 Accepting new patients
Appalachia Pathology Consultants LLC Current Accepting new patients
Logan General Hospital LLC Family Medicine CurrentSince Jan 1, 2023 Accepting new patients
St. Mary's Medical Management, LLC Family Medicine CurrentSince Jan 1, 2015 Accepting new patients
St Marys Medical Center, Inc. Past Accepting new patients
Trinity Health Care Services of Logan Inc Past Accepting new patients

Locations

3012 Champion Dr
Barboursville, WV 25504
Phone (304) 736-8764

2827 5th Ave
Huntington, WV 25702
Phone (304) 399-7182

2900 1st Ave
Huntington, WV 25702
Phone (304) 526-1111

3075 US Route 60
Huntington, WV 25705
Phone (304) 733-0004

135 Bills Branch Rd
Logan, WV 25601
Phone (304) 752-8723

20 Hospital Dr
Logan, WV 25601
Phone (304) 792-1101

60 Hospital Dr
Logan, WV 25601
Phone (304) 831-0073

77 Hospital Dr
Fl 4
Logan, WV 25601
Phone (304) 831-1663

Interoperability endpoints

  • Direct secure messaging: roderick.young.1@26088.direct.athenahealth.com

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 17

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

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744070400000",
    "number": "1235295072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4190",
            "city": "BARBOURSVILLE",
            "state": "WV",
            "postal_code": "255044190",
            "telephone_number": "304-399-4405",
            "fax_number": "304-399-2526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 HOSPITAL DR",
            "city": "LOGAN",
            "state": "WV",
            "postal_code": "256013452",
            "telephone_number": "304-831-1335"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3012 Champion Dr",
            "address_purpose": "LOCATION",
            "city": "Barboursville",
            "state": "WV",
            "postal_code": "255049343",
            "country_code": "US",
            "telephone_number": "304-736-8764 x102",
            "fax_number": "304-736-2699",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2827 5th Ave",
            "address_purpose": "LOCATION",
            "city": "Huntington",
            "state": "WV",
            "postal_code": "257021435",
            "country_code": "US",
            "telephone_number": "304-399-7182",
            "fax_number": "304-523-7738",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5430 MacCorkle Ave SE",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "WV",
            "postal_code": "253042224",
            "country_code": "US",
            "telephone_number": "304-925-3627",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2827 5th Ave",
            "address_purpose": "LOCATION",
            "city": "Huntington",
            "state": "WV",
            "postal_code": "257021435",
            "country_code": "US",
            "telephone_number": "304-399-7182",
            "fax_number": "304-523-7738",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "RODERICK",
        "middle_name": "ALLEN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-28",
        "last_updated": "2025-04-08",
        "certification_date": "2025-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WV",
            "license": "18830",
            "primary": false
        },
        {
            "code": "2083X0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Occupational Medicine",
            "state": "WV",
            "license": "18830",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "roderick.young@smmm.cernerdirect.com",
            "affiliation": "N",
            "address_1": "2827 5th Ave",
            "city": "Huntington",
            "state": "WV",
            "country_code": "US",
            "postal_code": "257021435",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Logan, WV

Sources for this page

Verify at the official NPI Registry.