Active NPI
Mike Scott Young, CP,LP
- Prosthetics Case Management
- Corpus Christi, TX
National Provider Identifier
1669404976
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthetics Case Management
- License
- 224
- Practice address
- 6901 S Padre Island Dr
103B
Corpus Christi, TX 78412-4929 - Phone
- (361) 992-7016
- Fax
- (361) 992-7369
- NPI assigned
- Jul 7, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Prosthetics Case Management | 1744P3200X | 224 | TX | Primary |
Addresses
Primary practice location
6901 S Padre Island Dr
103B
Corpus Christi, TX 78412-4929
Mailing address
6901 S Padre Island Dr
103B
Corpus Christi, TX 78412-4929
Phone (361) 992-7016
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 010037201 | Medicaid | TX |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 224 | TX | MD | Prosthetics Case Management |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bay Area Prosthetics Inc | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Prosthetic/Orthotic Supplier
- Corpus Christi, TX
- NPI 1528256724
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152230400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1433808000000",
"number": "1669404976",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6901 S PADRE ISLAND DR",
"address_2": "103B",
"city": "CORPUS CHRISTI",
"state": "TX",
"postal_code": "784124929",
"telephone_number": "361-992-7016",
"fax_number": "361-992-7369"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6901 S PADRE ISLAND DR",
"address_2": "103B",
"city": "CORPUS CHRISTI",
"state": "TX",
"postal_code": "784124929",
"telephone_number": "361-992-7016",
"fax_number": "361-992-7369"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YOUNG",
"first_name": "MIKE",
"middle_name": "SCOTT",
"name_prefix": "Mr.",
"credential": "CP,LP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-07",
"last_updated": "2015-06-09",
"status": "A"
},
"taxonomies": [
{
"code": "1744P3200X",
"taxonomy_group": "",
"desc": "Specialist, Prosthetics Case Management",
"state": "TX",
"license": "224",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "010037201",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Corpus Christi, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.