NPIMap

Individual provider Active NPI

Richard David Young, PA-C

  • Physician Assistant
  • Raeford, NC
National Provider Identifier
1659358372
Registry record updated May 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
103257 Issued in NC
Practice address
210 Medical Pavilion Dr
Raeford, NC 28376
Phone
(910) 904-8000
NPI assigned
Dec 22, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 21, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 103257 NC Primary

Addresses

Primary practice location

210 Medical Pavilion Dr
Raeford, NC 28376

Mailing address

200 Corporate Blvd
Lafayette, LA 70508-3870
Phone (800) 893-9698

Other practice location 1

720 Sarazen Dr
Clayton, NC 27527-3918
Phone (919) 553-1869

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041018000119 NC Practitioner - Physician Assistant 7315907003 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
95.06 of 100Reported as group
Quality
83.09
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
103257NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Vidant Medical Group LLC CurrentSince Oct 15, 2010 Accepting new patients
North Carolina Em-1 Medical Services, PC Physician Assistant CurrentSince Mar 1, 2009 Accepting new patients
Golden Grove Emergency Physicians Past Accepting new patients
Spruce Pine Emergency Services PLLC Past Accepting new patients
Lumberton Emergency Medical Associates PC PastSince Oct 1, 2023 Accepting new patients
Henderson Emergency Physicians, PLLC Past Accepting new patients
Carolina Coast Emergency Physicians LLC Past Accepting new patients
Bestpractices of North Carolina PC Past Accepting new patients
North Carolina Emergency Physicians, PLLC PastSince Feb 9, 2020 Accepting new patients

Locations

401 N Main St
Kenansville, NC 28349
Phone (910) 296-0941

100 Hospital Dr
Louisburg, NC 27549
Phone (252) 438-4143

958 US Highway 64 E
Plymouth, NC 27962
Phone (252) 793-3523

250 Smith Church Rd
Roanoke Rapids, NC 27870
Phone (252) 308-9699

615 Ridge Rd
Roxboro, NC 27573
Phone (336) 503-5699

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

Organizations & group practices 15

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.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1135209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558396800000",
    "number": "1659358372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 CORPORATE BLVD",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705083870",
            "telephone_number": "800-893-9698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 MEDICAL PAVILION DR",
            "city": "RAEFORD",
            "state": "NC",
            "postal_code": "28376",
            "telephone_number": "910-904-8000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "720 Sarazen Dr",
            "address_purpose": "LOCATION",
            "city": "Clayton",
            "state": "NC",
            "postal_code": "275273918",
            "country_code": "US",
            "telephone_number": "919-553-1869",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "RICHARD",
        "middle_name": "DAVID",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-22",
        "last_updated": "2019-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "103257",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raeford, NC

Sources for this page

Verify at the official NPI Registry.