Clinic at CC Young

Primary specialty

Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X

Legal business name

CLINIC AT CC YOUNG

Practice address

4847 W Lawther Dr
Ste 100
Dallas, TX 75214-1853

Phone

(214) 827-8080

NPI assigned

Oct 12, 2016

Last updated

Nov 8, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Russel Crews

Title

Ceo

Phone

(214) 827-8080

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1476230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1478563200000",
    "number": "1659821809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4847 W LAWTHER DR",
            "address_2": "STE 100",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752141853",
            "telephone_number": "214-827-8080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4847 W LAWTHER DR",
            "address_2": "STE 100",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752141853",
            "telephone_number": "214-827-8080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINIC AT CC YOUNG",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-12",
        "last_updated": "2016-11-08",
        "status": "A",
        "authorized_official_last_name": "CREWS",
        "authorized_official_first_name": "RUSSEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "214-827-8080"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Michael Cline, PA-C
• Lindsay Cline, MD
• Mallorie Taylor Cline, MD
• Lynda Faye Clinger, OTR
• Clinic at C. C. Young (Community Clinic at C. C. Young)
• Clinic at Cedar Springs
• Clinica America, P.a.
• Clinica Dental of Texas PLLC
• Clinica Familiar Peralta LLC
• Clinica Guadalupe Fort Worth LLC

• Geriatric Medicine (Family Medicine) Physician in Dallas, TX
• Providers in Dallas, TX by specialty
• Geriatric Medicine (Family Medicine) Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.