Elwood M Young OD PC

Primary specialty

OptometristTaxonomy code 152W00000X

License

01809 Issued in IA

Legal business name

ELWOOD M YOUNG OD PC

Practice address

406 1St St
Glenwood, IA 51534-1706

Phone

(712) 527-4468

Fax

(712) 527-9458

NPI assigned

Mar 23, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Jacque Diane Young, OD

Title

Owner

Phone

(712) 527-4468

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Young Vision Care Doing business as

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Travis Jones, OD

  • Optometrist
  • Council Bluffs, IA
  • NPI 1720464878
  NPD (past)
• Kyle Klute

  • Optometrist
  • Battle Creek, MI
  • NPI 1235556804
  NPD (past)

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

{
    "created_epoch": "1174608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320796800000",
    "number": "1376660340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "406 1ST ST",
            "address_2": "PO BOX 188",
            "city": "GLENWOOD",
            "state": "IA",
            "postal_code": "515341706",
            "telephone_number": "712-527-4468",
            "fax_number": "712-527-9458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "406 1ST ST",
            "city": "GLENWOOD",
            "state": "IA",
            "postal_code": "515341706",
            "telephone_number": "712-527-4468",
            "fax_number": "712-527-9458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELWOOD M YOUNG OD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-23",
        "last_updated": "2011-11-09",
        "status": "A",
        "authorized_official_last_name": "YOUNG",
        "authorized_official_first_name": "JACQUE",
        "authorized_official_middle_name": "DIANE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "712-527-4468",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "IA",
            "license": "01809",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0038547",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "410015491",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Young Vision Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Department of Human Services Glenwood Resource Center
• Department of Human Services Glenwood Resource Center
• Department of Human Services Glenwood Resource Center
• Kimberly Kay Durbin, LMHC
• Clinton Scott Eanes, NRP
• Embrace Iowa Inc
• Embrace LLC
• Amy Renee Faust, L.M.H.C.
• Lisa Maria Fiala
• Rebecca Lee Fipps, RBT

• Optometrist in Glenwood, IA
• Providers in Glenwood, IA by specialty
• Optometrist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 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.