Individual provider Active NPI

William Young, LPN

  • Licensed Practical Nurse
  • St Petersburg, FL
National Provider Identifier
1508216508
Registry record updated Jun 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
PN5159056 Issued in FL
Practice address
10033 Doctor M.L.K. Jr St N
St Petersburg, FL 33716
Phone
(800) 939-1643
NPI assigned
Jun 21, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X PN5159056 FL Primary

Addresses

Primary practice location

10033 Doctor M.L.K. Jr St N
St Petersburg, FL 33716

Mailing address

8466 Lockwood Ridge Rd
#340
Sarasota, FL 34243-2951
Phone (800) 939-1643

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

State licenses

LicenseStateTypeSpecialty
PN5159056FLMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Sanar Management, LLC. Past Accepting new patients

Organizations & group practices 1

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": "1466467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466467200000",
    "number": "1508216508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8466 LOCKWOOD RIDGE RD",
            "address_2": "#340",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342432951",
            "telephone_number": "800-939-1643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10033 DOCTOR M.L.K. JR ST N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "33716",
            "telephone_number": "800-939-1643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "WILLIAM",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-21",
        "last_updated": "2016-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "FL",
            "license": "PN5159056",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2016; 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.