Active NPI
Mary Kate Young, NP
- Nurse Practitioner
- Coushatta, LA
National Provider Identifier
1306979554
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- AP03477
- Practice address
- 1633 Marvel St
Coushatta, LA 71019-9022 - Phone
- (318) 932-2222
- Fax
- (318) 932-2186
- NPI assigned
- Mar 14, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | AP03477 | LA | Primary |
Addresses
Primary practice location
1633 Marvel St
Coushatta, LA 71019-9022
Mailing address
919 Hidden RDG
Irving, TX 75038-3813
Phone (469) 282-2711
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1180653 | Medicaid | LA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine, Nurse Practitioner
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173830400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1484784000000",
"number": "1306979554",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "919 HIDDEN RDG",
"city": "IRVING",
"state": "TX",
"postal_code": "750383813",
"telephone_number": "469-282-2711",
"fax_number": "469-282-0996"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1633 MARVEL ST",
"city": "COUSHATTA",
"state": "LA",
"postal_code": "710199022",
"telephone_number": "318-932-2222",
"fax_number": "318-932-2186"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YOUNG",
"first_name": "MARY",
"middle_name": "KATE",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-14",
"last_updated": "2017-01-19",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "LA",
"license": "AP03477",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1180653",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Coushatta, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2017; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.