Individual provider Active NPI

Jeremy Daniel Young, APRN

  • Family Nurse Practitioner
  • Savannah, GA
National Provider Identifier
1255014882
Registry record updated Sep 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN248507 Issued in GA
Practice address
6602 Waters Ave BLDG C
Savannah, GA 31406-2778
Phone
(912) 354-7676
NPI assigned
Aug 10, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 15, 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 RN248507 GA Primary

Addresses

Primary practice location

6602 Waters Ave BLDG C
Savannah, GA 31406-2778

Mailing address

40 Coffee Pointe Dr
Savannah, GA 31419-3169
Phone (912) 659-3726

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20230921004140 GA Practitioner - Nurse Practitioner 4385098532 Reassigns benefits to 1 organization

Care Compare profile

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

Practice addresses (Care Compare)

6602 Waters Ave
BLDG C
Savannah, GA 31406-2778
Phone (912) 354-7676

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN248507GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Savannah Neurology Specialists P C CurrentSince Aug 31, 2023 Accepting new patients

Locations

6602 Waters Ave
Bldg C
Savannah, GA 31406
Phone (912) 354-7676

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1691625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694736000000",
    "number": "1255014882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 COFFEE POINTE DR",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314193169",
            "telephone_number": "912-659-3726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6602 WATERS AVE BLDG C",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314062778",
            "telephone_number": "912-354-7676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "JEREMY",
        "middle_name": "DANIEL",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-08-10",
        "last_updated": "2023-09-15",
        "certification_date": "2023-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN248507",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Savannah, GA

Sources for this page

Verify at the official NPI Registry.