Active NPI
Sylvia Lysandra Young, NP
- Family Nurse Practitioner
- Pueblo, CO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 5964
- Practice address
- 902 Lakeview Ave
Pueblo, CO 81004-3597 - Phone
- (719) 557-5855
- Fax
- (719) 557-5097
- NPI assigned
- May 21, 2009
- Last updated
- Jun 26, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 5964 | CO | |
| Family Nurse Practitioner | 363LF0000X | 5964 | CO | Primary |
Addresses
Primary practice location
902 Lakeview Ave
Pueblo, CO 81004-3597
Mailing address
902 Lakeview Ave
Pueblo, CO 81004-3597
Phone (719) 557-5855
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL, DC, MS, MD
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 4
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1171 Hart St
Canton, MS 39046-4805
Phone (601) 859-9888
3070 Crain Hwy
Suite 101
Waldorf, MD 20601-2831
Phone (301) 645-3556
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5964 | CO | MD | Licensed Practical Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| PSP Medical Clinic | Current | Accepting new patients | |
| PSP Medical Clinic LLC | Current | Accepting new patients | |
| Health Partners, Inc. | Current | Accepting new patients | |
| Infinite Medical PC | Current | Accepting new patients |
Locations
220 Sierra Dr
North Miami Beach, FL 33179
Phone (305) 653-8427
4375 Port Tobacco Rd
Nanjemoy, MD 20662
Phone (301) 645-3556
3070 Crain Hwy
Ste 101
Waldorf, MD 20601
Phone (301) 645-3556
1171 Hart St
Canton, MS 39046
Phone (601) 859-9888
2629 Courthouse Cir
Flowood, MS 39232
Phone (601) 362-0611
1435 Grand Ave
Yazoo City, MS 39194
Phone (662) 532-2399
250 Skillman St
Ste 202
Brooklyn, NY 11205
Interoperability endpoints
- sylvia.young.p1@direct.magnoliamedical.nextgenshare.com
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Primary Care Clinic/Center
- Waldorf, MD
- NPI 1649304460
-
dba Madison Canton Medical Clinic
- Rural Health Clinic/Center
- Canton, MS
- NPI 1932144243
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1242864000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1403740800000",
"number": "1265667190",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "902 LAKEVIEW AVE",
"city": "PUEBLO",
"state": "CO",
"postal_code": "810043597",
"telephone_number": "719-557-5855",
"fax_number": "719-557-5097"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "902 LAKEVIEW AVE",
"city": "PUEBLO",
"state": "CO",
"postal_code": "810043597",
"telephone_number": "719-557-5855",
"fax_number": "719-557-5097"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YOUNG",
"first_name": "SYLVIA",
"middle_name": "LYSANDRA",
"name_prefix": "Mrs.",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-05-21",
"last_updated": "2014-06-26",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "CO",
"license": "5964",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "CO",
"license": "5964",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Pueblo, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.