Individual provider Active NPI

Amy B. Young, FNP

  • Family Nurse Practitioner
  • Summerville, SC
National Provider Identifier
1649404757
Registry record updated Aug 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3891 Issued in SC
Practice address
213 W 4TH North St
Summerville, SC 29483-6541
Phone
(843) 873-0681
Fax
(843) 873-8749
NPI assigned
May 5, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 3891 SC Primary

Addresses

Primary practice location

213 W 4TH North St
Summerville, SC 29483-6541

Mailing address

201 Sigma Dr
Ste. 100
Summerville, SC 29486-7715
Phone (843) 873-1720

Other identifiers 2

IdentifierTypeStateIssuer
NP1429MedicaidSC
P00871891OtherSCRR MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090615000041 SC Practitioner - Nurse Practitioner 6709936719 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Curana Health of South Carolina PC CurrentSince Jul 1, 2017 Accepting new patients
CH Specialty Services SC LLC Family CurrentSince May 17, 2023 Accepting new patients

Locations

2375 Baker Hospital Blvd
North Charleston, SC 29405
Phone (843) 744-2750

6650 Rivers Ave
North Charleston, SC 29406
Phone (843) 260-5361

255 Midland Pkwy
Summerville, SC 29485
Phone (843) 821-5005

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 2

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": "1241481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472515200000",
    "number": "1649404757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 SIGMA DR",
            "address_2": "STE. 100",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294867715",
            "telephone_number": "843-873-1720",
            "fax_number": "843-873-1108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "213 W 4TH NORTH ST",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294836541",
            "telephone_number": "843-873-0681",
            "fax_number": "843-873-8749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "AMY",
        "middle_name": "B.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-05",
        "last_updated": "2016-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "3891",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP1429",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00871891",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Summerville, SC

Sources for this page

Verify at the official NPI Registry.