Individual provider Active NPI

Merris Young, MD

  • Occupational Medicine Physician
  • Tiffin, OH
National Provider Identifier
1629015482
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Medicine PhysicianTaxonomy code 2083X0100X
License
05356832 Issued in OH
Practice address
3101 W US Highway 224
Tiffin, OH 44883-8305
Phone
(419) 448-3820
Fax
(419) 448-3822
NPI assigned
Jun 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Medicine Physician 2083X0100X 05356832 OH Primary

Addresses

Primary practice location

3101 W US Highway 224
Tiffin, OH 44883-8305

Mailing address

6626 E 75TH Street
Ste 500
Indianapolis, IN 46250-2890

Other practice location 1

3125 S Scatterfield Rd Ste 100
Anderson, IN 46013-1804
Phone (765) 644-5025

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address myoung167174@eCommunityDirect.com Community Hospitals of Indiana, INC

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
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
05356832OHMDOccupational Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lima Memorial Joint Operating Company Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: myoung167174@ecommunitydirect.com

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": "1149120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1629015482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6626 E 75TH STREET",
            "address_2": "STE 500",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462502890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3101 W US HIGHWAY 224",
            "city": "TIFFIN",
            "state": "OH",
            "postal_code": "448838305",
            "telephone_number": "419-448-3820",
            "fax_number": "419-448-3822"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3125 S Scatterfield Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Anderson",
            "state": "IN",
            "postal_code": "460131804",
            "country_code": "US",
            "telephone_number": "765-644-5025",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "MERRIS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-01",
        "last_updated": "2023-11-27",
        "certification_date": "2020-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083X0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Occupational Medicine",
            "state": "OH",
            "license": "05356832",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "myoung167174@eCommunityDirect.com",
            "affiliation": "Y",
            "affiliationName": "Community Hospitals of Indiana, INC",
            "address_1": "3125 S Scatterfield Rd Ste 100",
            "city": "Anderson",
            "state": "IN",
            "country_code": "US",
            "postal_code": "460131804",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Tiffin, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; 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.