Individual provider Active NPI

Edward H Young, M.D.

  • Internal Medicine Physician
  • Macon, GA
National Provider Identifier
1356494595
Registry record updated Dec 9, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036325 Issued in GA
Practice address
6501 Peake Rd
#700
Macon, GA 31210-8042
Phone
(478) 476-9285
NPI assigned
Jan 19, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2009

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 036325 GA Primary

Addresses

Primary practice location

6501 Peake Rd
#700
Macon, GA 31210-8042

Mailing address

6501 Peake Rd
#700
Macon, GA 31210-8042
Phone (478) 476-9285

Other identifiers 2

IdentifierTypeStateIssuer
000518207GMedicaidGA
52029199OtherGABCBS OF GEORGIA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040907000220 GA Practitioner - Internal Medicine 3476440769 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Mercer University School of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cogent Healthcare of Macon, LLCGroup PAC ID 9234104019, 73 clinicians

Practice addresses (Care Compare)

777 Hemlock St
Macon, GA 31201-2102
Phone (478) 633-7444

821 N Cobb St
Milledgeville, GA 31061-2343
Phone (478) 633-7550

Hospital & facility affiliations

  • Atrium Health Navicent at Home Home health agency, Macon, GA, CCN 117023
  • Atrium Health Navicent the Medical Center Hospital, Macon, GA, CCN 110107
  • Navicent Health Baldwin Hospital, Milledgeville, GA, CCN 110150

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036325GAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cogent Healthcare of Macon, LLC Internal Medicine CurrentSince Jul 19, 2004 Accepting new patients
Hospital Specialists, PC Internal Medicine PastSince Jun 1, 1998 Accepting new patients
Hospital Specialists of Dublin, PC Internal Medicine Past Accepting new patients

Locations

777 Hemlock St
Macon, GA 31201
Phone (478) 474-5600

777 Hemlock St
#104
Macon, GA 31201
Phone (478) 633-7550

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 3

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": "1169164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260316800000",
    "number": "1356494595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6501 PEAKE RD",
            "address_2": "#700",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312108042",
            "telephone_number": "478-476-9285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6501 PEAKE RD",
            "address_2": "#700",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312108042",
            "telephone_number": "478-476-9285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "EDWARD",
        "middle_name": "H",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-19",
        "last_updated": "2009-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "036325",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000518207G",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF GEORGIA",
            "identifier": "52029199",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Macon, GA

Sources for this page

Verify at the official NPI Registry.