Kerry Alisa Young, RN

Primary specialty

General Practice Registered NurseTaxonomy code 163WG0000X

License

RN2357655 Issued in MA

Practice address

235 Greenfield Rd
South Deerfield, MA 01373-9753

Phone

(413) 658-5782

NPI assigned

Aug 26, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Kerry Alisa Smith Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1724630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724630400000",
    "number": "1235962150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "268 W PELHAM RD",
            "city": "SHUTESBURY",
            "state": "MA",
            "postal_code": "010729704",
            "telephone_number": "413-658-5782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 GREENFIELD RD",
            "city": "SOUTH DEERFIELD",
            "state": "MA",
            "postal_code": "013739753",
            "telephone_number": "413-658-5782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "KERRY",
        "middle_name": "ALISA",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-08-26",
        "last_updated": "2024-08-26",
        "certification_date": "2024-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "MA",
            "license": "RN2357655",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KERRY",
            "last_name": "SMITH",
            "middle_name": "ALISA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Renato Wendel, LIC. AC.
• Lee White
• Sarah E Winston
• Francia Elena Wisnewski, MED
• Richard K Wu, MD
• Gregory Dean Zimmerman, M.S.W., L.I.C.S.W.

• General Practice Registered Nurse in South Deerfield, MA
• Providers in South Deerfield, MA by specialty
• General Practice Registered Nurse in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.