Individual provider Active NPI

Anna G Young, M.D.

  • Family Medicine Physician
  • Charlevoix, MI
National Provider Identifier
1376534495
Registry record updated Dec 31, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301059816 Issued in MI
Practice address
14705 W Upright St
Charlevoix, MI 49720-1949
Phone
(231) 547-8777
Fax
(231) 547-8638
NPI assigned
Oct 31, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4301059816 MI Primary

Addresses

Primary practice location

14705 W Upright St
Charlevoix, MI 49720-1949

Mailing address

14705 W Upright St
Charlevoix, MI 49720-1949
Phone (231) 547-8777

Other identifiers 2

IdentifierTypeStateIssuer
080071539OtherMIRAILROAD MEDICARE
2843314MedicaidMI

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ANNAYOUNG@cah.cernerdirect.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20100820000477 MI Practitioner - Family Practice 4789718164 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Munson Healthcare Charlevoix Hospital Family Medicine CurrentSince Jan 1, 2014 Accepting new patients
Munson Healthcare Charlevoix Hospital Family Medicine CurrentSince Jan 1, 2014 Accepting new patients
Munson Healthcare Charlevoix Hospital Past Accepting new patients

Locations

4880 Momentum Pl
Chicago, IL 60689

14709 W Upright St
Charlevoix, MI 49720
Phone (231) 547-6519

14705 W Upright St
Charlevoix, MI 49720
Phone (231) 547-6519

14700 Lake Shore Dr
Charlevoix, MI 49720
Phone (231) 547-3840

Interoperability endpoints

  • Direct secure messaging: annayoung@cah.cernerdirect.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1130716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609372800000",
    "number": "1376534495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14705 W UPRIGHT ST",
            "city": "CHARLEVOIX",
            "state": "MI",
            "postal_code": "497201949",
            "telephone_number": "231-547-8777",
            "fax_number": "231-547-8638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14705 W UPRIGHT ST",
            "city": "CHARLEVOIX",
            "state": "MI",
            "postal_code": "497201949",
            "telephone_number": "231-547-8777",
            "fax_number": "231-547-8638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "ANNA",
        "middle_name": "G",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-31",
        "last_updated": "2020-12-31",
        "certification_date": "2020-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301059816",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "080071539",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2843314",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ANNAYOUNG@cah.cernerdirect.com",
            "affiliation": "N",
            "address_1": "14705 W Upright St",
            "city": "Charlevoix",
            "state": "MI",
            "country_code": "US",
            "postal_code": "497201949",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charlevoix, MI

Sources for this page

Verify at the official NPI Registry.