NPIMap

Individual provider Active NPI

David Russell Young, MD

  • Interventional Cardiology Physician
  • Jackson, MS
National Provider Identifier
1366487365
Registry record updated Mar 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
13925 Issued in MS
Practice address
970 Lakeland Dr
Suite 61
Jackson, MS 39216-4635
Phone
(601) 982-7850
Fax
(601) 718-5145
NPI assigned
Jun 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 13925 MS
Interventional Cardiology Physician 207RI0011X 13925 MS Primary

Addresses

Primary practice location

970 Lakeland Dr
Suite 61
Jackson, MS 39216-4635

Mailing address

970 Lakeland Dr Ste 40
Jackson, MS 39216-4640
Phone (601) 982-7850

Other practice location 1

969 Lakeland Dr
Jackson, MS 39216-4606
Phone (601) 200-2000

Other identifiers 1

IdentifierTypeStateIssuer
00119854MedicaidMS

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address d.russell.young@direct.jacksonheart.nextgenshare.com

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080527000361 MS Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology) 1951313287 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Interventional Cardiology
Education
University of Mississippi School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St. Dominic Jackson MemorialGroup PAC ID 4385531847, 56 clinicians
Jackson Heart Clinic. P.a.Group PAC ID 0547204091, 40 clinicians

Practice addresses (Care Compare)

969 Lakeland Dr
Jackson, MS 39216-4606
Phone (601) 364-6175

970 Lakeland Dr
Suite 61
Jackson, MS 39216-4634
Phone (601) 982-7850

Hospital & facility affiliations

  • St Dominic-Jackson Memorial Hospital Hospital, Jackson, MS, CCN 250048
  • King'S Daughters Medical Center-Brookhaven Hospital, Brookhaven, MS, CCN 250057
  • Southwest Ms Regional Medical Center Hospital, McComb, MS, CCN 250097
  • Greenwood Leflore Hospital Hospital, Greenwood, MS, CCN 250099
  • North Sunflower Medical Center Cah Hospital, Ruleville, MS, CCN 251318

Merit-based Incentive Payment System (MIPS)

Final score
86.07 of 100Reported as group
Quality
74.67
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting86
Pacemaker insertion or repair1-10
Varicose vein removal13
Leg revascularization (restoring blood flow)15

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Jackson Heart Clinic. P.a. Cardiovascular Disease CurrentSince Jun 22, 1998 Accepting new patients
St. Dominic Jackson Memorial CurrentSince Aug 19, 2012 Accepting new patients
St Dominic Hospital Crna'S CurrentSince Aug 19, 2012 Accepting new patients
Brandon Hma LLC Past Accepting new patients
State of Mississippi - University of Mississippi Medical Center Past Accepting new patients
River Oaks Management Company LLC Interventional Cardiology Past Accepting new patients
Radiology Services P a Past Accepting new patients

Locations

185 Medical Pkwy
Ste 202
Flowood, MS 39232

970 Lakeland Dr
Ste 61
Jackson, MS 39216
Phone (601) 200-2780

969 Lakeland Dr
Jackson, MS 39216
Phone (601) 200-4644

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 7

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 5

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": "1150502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741651200000",
    "number": "1366487365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "970 LAKELAND DR STE 40",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164640",
            "telephone_number": "601-982-7850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "970 LAKELAND DR",
            "address_2": "SUITE 61",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164635",
            "telephone_number": "601-982-7850",
            "fax_number": "601-718-5145"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "969 Lakeland Dr",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "MS",
            "postal_code": "392164606",
            "country_code": "US",
            "telephone_number": "601-200-2000",
            "fax_number": "601-200-0166",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "DAVID",
        "middle_name": "RUSSELL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-17",
        "last_updated": "2025-03-11",
        "certification_date": "2025-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MS",
            "license": "13925",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "MS",
            "license": "13925",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00119854",
            "state": "MS"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "d.russell.young@direct.jacksonheart.nextgenshare.com",
            "affiliation": "N",
            "address_1": "970 Lakeland Dr",
            "address_2": "Suite 61",
            "city": "Jackson",
            "state": "MS",
            "country_code": "US",
            "postal_code": "392164635",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

Verify at the official NPI Registry.