Individual provider Active NPI

Timothy Blake Young, PHARM.D., MBA

  • Pharmacist
  • Chattanooga, TN
National Provider Identifier
1639521644
Registry record updated Nov 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
40166 Issued in TN
Practice address
1200 Mountain Creek Rd Ste 440
Chattanooga, TN 37405-6101
Phone
(423) 206-9840
Fax
(423) 206-9841
NPI assigned
Jul 1, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 14, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 26111 NC
Pharmacist 183500000X 40166 TN Primary

Addresses

Primary practice location

1200 Mountain Creek Rd Ste 440
Chattanooga, TN 37405-6101

Mailing address

1630 Andrews Rd
Murphy, NC 28906-5100

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
Credentials
Master of Business Administration, Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
26111NCMDPharmacist
40166TNMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Rciv, LLC CurrentSince Nov 19, 2023 Accepting new patients
Walgreen Co Past Accepting new patients
Caresouth HHA Holdings of Winchester, LLC PastSince Nov 19, 2023 Accepting new patients
Walgreen Co PastSince May 8, 2022 Accepting new patients

Locations

1200 Mountain Creek Rd
Ste 440
Chattanooga, TN 37405
Phone (423) 206-9840

Organizations & group practices 4

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": "1467331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699920000000",
    "number": "1639521644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1630 ANDREWS RD",
            "city": "MURPHY",
            "state": "NC",
            "postal_code": "289065100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 MOUNTAIN CREEK RD STE 440",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374056101",
            "telephone_number": "423-206-9840",
            "fax_number": "423-206-9841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "TIMOTHY",
        "middle_name": "BLAKE",
        "name_prefix": "Dr.",
        "credential": "PHARM.D., MBA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-07-01",
        "last_updated": "2023-11-14",
        "certification_date": "2023-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NC",
            "license": "26111",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TN",
            "license": "40166",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chattanooga, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 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.