Stacey L. Young, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OH4648 Issued in OH

Practice address

4139 Fulton Dr NW
Canton, OH 44718-2819

Phone

(330) 966-2400

Fax

(330) 966-0114

NPI assigned

Sep 7, 2006

Last updated

Oct 27, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Stacey Young OD Inc

  dba Eyecare Specialties

  • Optometrist
  • Canton, OH
  • NPI 1558807826
  Authorized official Same address or phone

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

{
    "created_epoch": "1157587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698364800000",
    "number": "1538262340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9487 COBLENTZ AVE NW",
            "city": "UNIONTOWN",
            "state": "OH",
            "postal_code": "446857692",
            "telephone_number": "330-966-2400",
            "fax_number": "330-966-0114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4139 FULTON DR NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447182819",
            "telephone_number": "330-966-2400",
            "fax_number": "330-966-0114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "STACEY",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-07",
        "last_updated": "2023-10-27",
        "certification_date": "2023-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "OH4648",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2373864",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marcia Lynn Young
• Marcy Lynn Young
• Maria Siobhanne Young, M.D.
• Megan Young
• Shanae Onika Young, PT
• Tanya Marie Young, AGACNP-BC
• Terrell Young, MAED.
• Asif Younus, MD
• Your Home Court Advantage LLC (Amivie)
• Your Home Court Advantage, LLC (Amivie)

• Optometrist in Canton, OH
• Providers in Canton, OH by specialty
• Optometrist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.