Joseph Theodore Young, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

2008028220 Issued in MO

Practice address

1015 Bowles Ave
Fenton, MO 63026

Phone

(636) 496-2000

Fax

(314) 996-1681

NPI assigned

Dec 22, 2005

Last updated

Aug 19, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Little Blue Emergency Physicians LLC

  • Emergency Medicine Physician
  • Independence, MO
  • NPI 1609154061
  NPD (past)
• Missouri Em-I Medical Services, P.C.

  • Emergency Medicine Physician
  • Independence, MO
  • NPI 1245518604
  NPD (past)
• Acs Primary Care Physicians Southwest, PA

  • Emergency Medicine Physician
  • Gainesville, TX
  • NPI 1538101019
  NPD (past)
• Odessa Physician Associates, PLLC

  • Emergency Medicine Physician
  • Odessa, TX
  • NPI 1457398364
  NPD (past)
• Southeastern Emergency Physicians of Memphis LLC

  • Emergency Medicine Physician
  • Alton, IL
  • NPI 1437105277
  NPD (past)

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

{
    "created_epoch": "1135209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566172800000",
    "number": "1437135217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4297",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803064297",
            "telephone_number": "303-518-1931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 BOWLES AVE",
            "city": "FENTON",
            "state": "MO",
            "postal_code": "63026",
            "telephone_number": "636-496-2000",
            "fax_number": "314-996-1681"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4500 Baseline Rd Apt 2404",
            "address_purpose": "LOCATION",
            "city": "Boulder",
            "state": "CO",
            "postal_code": "803038220",
            "country_code": "US",
            "telephone_number": "303-518-1931",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 Medical Plz",
            "address_purpose": "LOCATION",
            "city": "Lake St Louis",
            "state": "MO",
            "postal_code": "633671366",
            "country_code": "US",
            "telephone_number": "636-625-5200",
            "fax_number": "636-625-5314",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "JOSEPH",
        "middle_name": "THEODORE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-22",
        "last_updated": "2019-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "F3008",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CO",
            "license": "23542",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "C50185",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MO",
            "license": "2008028220",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE INDIVIDUAL PTAN NUMBER",
            "identifier": "P00691434",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01235423",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Laura K Wolters, PT, DPT
• Nirandon Wongsurawat, MD
• Steven Michael Workman, D.M.D.
• Wuca-Fenton Pediatrics, LLC
• Michelle L Yepez, RPH
• Sheikh M Zahid, M.D.
• Patricia M Zelle, RD, LD
• Matthew Thomas Zimmerman, DO
• Elaine Marie Zobrist, NP-C
• Michael Ryan Zwiener, D.C.

• Emergency Medicine Physician in Fenton, MO
• Providers in Fenton, MO by specialty
• Emergency Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2019; 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.