Individual provider Active NPI

Marie Katherine Young, LPN

  • Home Health Agency
  • St Augustine, FL
National Provider Identifier
1316255953
Registry record updated Sep 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
PN889621 Issued in FL
Practice address
803 Wynfield Circle
St. Augustine, FL 32092
Phone
(904) 940-9436
Fax
(904) 940-9436
NPI assigned
Sep 16, 2010
Last updated
Sep 16, 2010By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 16, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X PN889621 FL Primary

Addresses

Primary practice location

803 Wynfield Circle
St. Augustine, FL 32092

Mailing address

803 Wynfield Circle
St. Augustine, FL 32092
Phone (904) 940-9436

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PN889621FLMDHome Health Agency

NPI Registry JSON

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

{
    "created_epoch": "1284595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1284595200000",
    "number": "1316255953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "803 WYNFIELD CIRCLE",
            "city": "ST. AUGUSTINE",
            "state": "FL",
            "postal_code": "32092",
            "telephone_number": "904-940-9436",
            "fax_number": "904-940-9436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "803 WYNFIELD CIRCLE",
            "city": "ST. AUGUSTINE",
            "state": "FL",
            "postal_code": "32092",
            "telephone_number": "904-940-9436",
            "fax_number": "904-940-9436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "MARIE",
        "middle_name": "KATHERINE",
        "name_prefix": "Ms.",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-09-16",
        "last_updated": "2010-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "FL",
            "license": "PN889621",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Augustine, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2010; 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.