Individual provider Active NPI

Gregory Douglas Young, DC

  • Chiropractor
  • Andrews, TX
National Provider Identifier
1306994066
Registry record updated Oct 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
8662 Issued in TX
Practice address
200 SE 1St St
Andrews, TX 79714-7115
Phone
(432) 524-5580
Fax
(432) 524-5583
NPI assigned
Jan 8, 2007
Last updated
Oct 14, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 14, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 8662 TX Primary

Addresses

Primary practice location

200 SE 1St St
Andrews, TX 79714-7115

Mailing address

200 SE 1St St
Andrews, TX 79714-7115
Phone (432) 524-5580

Other identifiers 2

IdentifierTypeStateIssuer
146738301MedicaidTX
607054OtherTXBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120109000960 TX Practitioner - Chiropractic 5193991396 Practice locations: Andrews, TX

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

200 SE 1St St
Andrews, TX 79714-7115
Phone (432) 524-5580

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Gregory D. Young, DC Chiropractor PastSince Aug 14, 2000 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318550400000",
    "number": "1306994066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 SE 1ST ST",
            "city": "ANDREWS",
            "state": "TX",
            "postal_code": "797147115",
            "telephone_number": "432-524-5580",
            "fax_number": "432-524-5583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 SE 1ST ST",
            "city": "ANDREWS",
            "state": "TX",
            "postal_code": "797147115",
            "telephone_number": "432-524-5580",
            "fax_number": "432-524-5583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "GREGORY",
        "middle_name": "DOUGLAS",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-08",
        "last_updated": "2011-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "8662",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "146738301",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "607054",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Andrews, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.