Active NPI
Lydia Mock Young, FNP
- Family Nurse Practitioner
- Baton Rouge, LA
National Provider Identifier
1326041849
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 4313
- Practice address
- 8595 Picardy Ave
Baton Rouge, LA 70809-3670 - Phone
- (225) 763-4950
- Fax
- (225) 763-4066
- NPI assigned
- May 30, 2005
- 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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 4313 | LA | Primary |
Addresses
Primary practice location
8595 Picardy Ave
Baton Rouge, LA 70809-3670
Mailing address
13127 Roddy Rd
Gonzales, LA 70737-7316
Phone (225) 763-4900
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1166839 | Medicaid | LA | |
| P00218784 | Other | LA | RAILROAD MEDICARE |
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)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4313 | LA | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lance E Bullock, MD, a Professional Medical Corporation | Past | Accepting new patients |
Interoperability endpoints
- thewellclinic.lydiayoung@132651.advancedmd-direct.com
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 and National Provider Directory roles.
-
- Psychiatry Physician
- Gonzales, LA
- NPI 1265465397
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1117411200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1247097600000",
"number": "1326041849",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13127 RODDY RD",
"city": "GONZALES",
"state": "LA",
"postal_code": "707377316",
"telephone_number": "225-763-4900",
"fax_number": "225-763-4066"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8595 PICARDY AVE",
"city": "BATON ROUGE",
"state": "LA",
"postal_code": "708093670",
"telephone_number": "225-763-4950",
"fax_number": "225-763-4066"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YOUNG",
"first_name": "LYDIA",
"middle_name": "MOCK",
"name_prefix": "Mrs.",
"credential": "FNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-05-30",
"last_updated": "2009-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "LA",
"license": "4313",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1166839",
"state": "LA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00218784",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Baton Rouge, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.