Individual provider Active NPI

Ray Young, MD

  • Surgery Physician
  • Alexandria, LA
National Provider Identifier
1366530479
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
A49123 Issued in CA
Practice address
2495 Shreveport Highway
Alexandria VA Medical Center
Alexandria, LA 71306-9004
Phone
(318) 473-0010
Fax
(318) 483-5117
NPI assigned
Oct 11, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X A49123 CA Primary

Addresses

Primary practice location

2495 Shreveport Highway
Alexandria VA Medical Center
Alexandria, LA 71306-9004

Mailing address

4325 Clubhouse Dr
Apt E14
Alexandria, LA 71303-3531
Phone (318) 473-0010

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)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A49123CAMDSurgery Physician

NPI Registry JSON

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1366530479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4325 CLUBHOUSE DR",
            "address_2": "APT E14",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713033531",
            "telephone_number": "318-473-0010",
            "fax_number": "318-483-5117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2495 SHREVEPORT HIGHWAY",
            "address_2": "ALEXANDRIA VA MEDICAL CENTER",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713069004",
            "telephone_number": "318-473-0010",
            "fax_number": "318-483-5117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "RAY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "A49123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alexandria, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.