Active NPI
Jill Trawick Young, FNP
- Family Nurse Practitioner
- Winston Salem, NC
National Provider Identifier
1508071549
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 59493
- Practice address
- 114 Charlois Blvd
Winston Salem, NC 27103-1522 - Phone
- (336) 765-5470
- Fax
- (336) 765-5428
- NPI assigned
- May 12, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 59493 | NC | Primary |
Addresses
Primary practice location
114 Charlois Blvd
Winston Salem, NC 27103-1522
Mailing address
PO Box 602362
Charlotte, NC 28260-2362
Phone (336) 765-5470
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)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 59493 | NC | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178928000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1323043200000",
"number": "1508071549",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 602362",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282602362",
"telephone_number": "336-765-5470",
"fax_number": "336-765-5428"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "114 CHARLOIS BLVD",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271031522",
"telephone_number": "336-765-5470",
"fax_number": "336-765-5428"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YOUNG",
"first_name": "JILL",
"middle_name": "TRAWICK",
"name_prefix": "Mrs.",
"credential": "FNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-12",
"last_updated": "2011-12-05",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "NC",
"license": "59493",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Winston Salem, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 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.