NPIMap

Organization Active NPI

James R. Young MD

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Nacogdoches, TX
National Provider Identifier
1336329457
Registry record updated Jan 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
K4616 Issued in TX
Legal business name
JAMES R. YOUNG MD
Practice address
4800 NE Stallings Dr
Suite 1600
Nacogdoches, TX 75965-1249
Phone
(936) 559-9019
Fax
(936) 462-7876
NPI assigned
Nov 6, 2007
Last updated
Jan 14, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2011

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

Authorized official

Name
Dr. James R Young, M.D.NPI 1427024074
Title
President
Phone
(936) 559-9019

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X K4616 TX Primary

Addresses

Primary practice location

4800 NE Stallings Dr
Suite 1600
Nacogdoches, TX 75965-1249

Mailing address

4800 NE Stallings Dr
Suite 1600
Nacogdoches, TX 75965-1249
Phone (936) 559-9019

Other identifiers 3

IdentifierTypeStateIssuer
0045LBOtherBC/BS
0089RMOtherTXBCBS
165815501MedicaidTX

National Provider Directory

National Provider Directory

Locations

1407 N University Dr
Ste C
Nacogdoches, TX 75961
Phone (936) 462-7575

4800 NE Stallings Dr
Ste 1600
Nacogdoches, TX 75965
Phone (936) 559-9019

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1194307200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1294963200000",
    "number": "1336329457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4800 NE STALLINGS DR",
            "address_2": "SUITE 1600",
            "city": "NACOGDOCHES",
            "state": "TX",
            "postal_code": "759651249",
            "telephone_number": "936-559-9019",
            "fax_number": "936-462-7876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4800 NE STALLINGS DR",
            "address_2": "SUITE 1600",
            "city": "NACOGDOCHES",
            "state": "TX",
            "postal_code": "759651249",
            "telephone_number": "936-559-9019",
            "fax_number": "936-462-7876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAMES R. YOUNG MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-06",
        "last_updated": "2011-01-14",
        "status": "A",
        "authorized_official_last_name": "YOUNG",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "936-559-9019",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "TX",
            "license": "K4616",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "0045LB",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0089RM",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "165815501",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Nacogdoches, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2011; 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.