NPIMap

Individual provider Active NPI

Elizabeth Johnson Young, MD

  • Internal Medicine Physician
  • Charleston, WV
National Provider Identifier
1316165103
Registry record updated Aug 7, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
22972 Issued in WV
Practice address
300 Kenton Dr
Suite 100
Charleston, WV 25311-1263
Phone
(304) 346-5533
Fax
(304) 346-5611
NPI assigned
Apr 24, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 22972 WV Primary

Addresses

Primary practice location

300 Kenton Dr
Suite 100
Charleston, WV 25311-1263

Mailing address

300 Kenton Dr
Suite100
Charleston, WV 25311-1263
Phone (304) 346-5533

Other identifiers 6

IdentifierTypeStateIssuer
P00189318OtherWVUMWA PIN NUMBER FOR GROUP
P00215125OtherWVRAILROAD NUMBER FOR THE GROUP
001706175OtherWVBLUE CROSS NUMBER FOR GROUP
1447349238OtherWVNPI NUMBER FOR THE GROUP
3810001081MedicaidWV
DC7713OtherWVUMWA NUMBER FOR GROUP

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090121000737 WV Practitioner - Internal MedicinePractitioner - Pediatric Medicine 0547324493 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Pediatric Medicine
Education
West Virginia University School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mountain State Medical Associates PLLCGroup PAC ID 8921062183, 6 clinicians

Practice addresses (Care Compare)

300 Kenton Dr
Suite 100
Charleston, WV 25311-1266
Phone (304) 346-5533

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Mountain State Medical Associates PLLC Internal Medicine CurrentSince Nov 1, 2011 Accepting new patients
Hospitalist Medicine Physicians of Charleston, PLLC Internal Medicine Past Accepting new patients
Jessica Beth Salansky MD PLLC Past Accepting new patients

Locations

300 Kenton Dr
Ste 100
Charleston, WV 25311
Phone (304) 346-5533

Interoperability endpoints

  • Direct secure messaging: eyoungmd@1edd1a2c.micromddirect.com

Organizations & group practices 3

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.

Hospital & facility affiliations 12

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375833600000",
    "number": "1316165103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 KENTON DR",
            "address_2": "SUITE100",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253111263",
            "telephone_number": "304-346-5533",
            "fax_number": "304-346-5611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 KENTON DR",
            "address_2": "SUITE 100",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253111263",
            "telephone_number": "304-346-5533",
            "fax_number": "304-346-5611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "ELIZABETH",
        "middle_name": "JOHNSON",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-24",
        "last_updated": "2013-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WV",
            "license": "22972",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UMWA PIN NUMBER FOR GROUP",
            "identifier": "P00189318",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD NUMBER FOR THE GROUP",
            "identifier": "P00215125",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS NUMBER FOR GROUP",
            "identifier": "001706175",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI NUMBER FOR THE GROUP",
            "identifier": "1447349238",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810001081",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UMWA NUMBER FOR GROUP",
            "identifier": "DC7713",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, WV

Sources for this page

Verify at the official NPI Registry.