NPIMap

Organization Active NPI

Young Orthopaedics & Sports Medicine, PA

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Jacksonville, FL
National Provider Identifier
1629378005
Registry record updated Jun 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
License
ME 96716 Issued in FL
Legal business name
YOUNG ORTHOPAEDICS & SPORTS MEDICINE, PA
Practice address
9191 R.G. Skinner Parkway
Suite 703
Jacksonville, FL 32256-9662
Phone
(904) 232-2000
Fax
(904) 230-6000
NPI assigned
Nov 1, 2010
Last updated
Jun 29, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2012

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

Authorized official

Name
Samuel D Young III, MD
Title
President
Phone
(904) 230-2000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X ME 96716 FL Primary

Addresses

Primary practice location

9191 R.G. Skinner Parkway
Suite 703
Jacksonville, FL 32256-9662

Mailing address

9191 R G Skinner Parkway
Suite #703
Jacksonville, FL 32256-9662
Phone (904) 232-2000

National Provider Directory

National Provider Directory

Locations

9191 R G Skinner Pkwy
Unit 703
Jacksonville, FL 32256
Phone (904) 230-2000

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1288569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1340928000000",
    "number": "1629378005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9191 R G SKINNER PARKWAY",
            "address_2": "SUITE #703",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322569662",
            "telephone_number": "904-232-2000",
            "fax_number": "904-230-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9191 R.G. SKINNER PARKWAY",
            "address_2": "SUITE 703",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322569662",
            "telephone_number": "904-232-2000",
            "fax_number": "904-230-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YOUNG ORTHOPAEDICS & SPORTS MEDICINE, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-01",
        "last_updated": "2012-06-29",
        "status": "A",
        "authorized_official_last_name": "YOUNG",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "904-230-2000",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "FL",
            "license": "ME 96716",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2012; 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.