Peter Bernhart Young, PHD

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

P-1466 Issued in TN

Practice address

10820 Kingston Pike
Suite 21
Knoxville, TN 37934-3066

Phone

(865) 671-6935

Fax

(865) 675-0502

NPI assigned

May 16, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1286928000000",
    "number": "1326090770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10820 KINGSTON PIKE",
            "address_2": "SUITE 21",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379343066",
            "telephone_number": "865-671-6935",
            "fax_number": "865-675-0502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10820 KINGSTON PIKE",
            "address_2": "SUITE 21",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379343066",
            "telephone_number": "865-671-6935",
            "fax_number": "865-675-0502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "PETER",
        "middle_name": "BERNHART",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-16",
        "last_updated": "2010-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "TN",
            "license": "P-1466",
            "primary": true
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "WV",
            "license": "718",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TN",
            "license": "P-1466",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WV",
            "license": "718",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3684340",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PSYCHOLOGY LICENSE #",
            "identifier": "718",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSSBLUESHIELD",
            "identifier": "2007179",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PSYCHOLOGY LICENSE #",
            "identifier": "P-1466",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marlee Young
• Megan Young
• Melissa Joyce Young
• Michael Eugene Young, PA
• Mischelle Marie Young, CPNP-PC
• Raisin Love Young, BA
• Richard Michael Young, M.D.
• Thomas L Young, MD
• Violeta Barraza Young
• Wednesday Nichole Young, MSSW

• Clinical Neuropsychologist in Knoxville, TN
• Providers in Knoxville, TN by specialty
• Clinical Neuropsychologist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 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.