Jeffrey Joe Young

Primary specialty

PACE Provider OrganizationTaxonomy code 251T00000X

Practice address

2129 Green Lee Lane
Dickinson, TX 77539-5152

Phone

(972) 308-7450

NPI assigned

May 8, 2017

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1494201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494201600000",
    "number": "1275069478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2202 TIMBER DR.",
            "city": "DICKINSON",
            "state": "TX",
            "postal_code": "775395152",
            "telephone_number": "972-308-7450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2129 GREEN LEE LANE",
            "city": "DICKINSON",
            "state": "TX",
            "postal_code": "775395152",
            "telephone_number": "972-308-7450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "JEFFREY",
        "middle_name": "JOE",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-05-08",
        "last_updated": "2017-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251T00000X",
            "taxonomy_group": "",
            "desc": "Program of All-Inclusive Care for the Elderly (PACE) Provider Organization",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• PACE Provider Organization in Dickinson, TX
• Providers in Dickinson, TX by specialty
• PACE Provider Organization in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2017; 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.