Individual provider Active NPI

Victoria Vincella Chin-Young, NP

  • Nurse Practitioner
  • Lilburn, GA
National Provider Identifier
1669625836
Registry record updated Dec 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN265573 Issued in GA
Practice address
950 Indian Trail Lilburn Rd NW
Lilburn, GA 30047-1721
Phone
(470) 545-2131
NPI assigned
Oct 31, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 21, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 604593-1 NY
Nurse Practitioner 363L00000X RN265573 GA Primary

Addresses

Primary practice location

950 Indian Trail Lilburn Rd NW
Lilburn, GA 30047-1721

Mailing address

950 Indian TRL Rd NW
Lilburn, GA 30047-1721
Phone (470) 545-2131

Other practice location 1

10201 66th Rd
Forest Hills, NY 11375-2029
Phone (718) 830-4000

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
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
604593-1NYMDRegistered Nurse
RN265573GAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Georgia Prenatal LLC PastSince Nov 10, 2019 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.

NPI Registry JSON

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

{
    "created_epoch": "1225411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640044800000",
    "number": "1669625836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 INDIAN TRL RD NW",
            "city": "LILBURN",
            "state": "GA",
            "postal_code": "300471721",
            "telephone_number": "470-545-2131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 INDIAN TRAIL LILBURN RD NW",
            "city": "LILBURN",
            "state": "GA",
            "postal_code": "300471721",
            "telephone_number": "470-545-2131"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10201 66th Rd",
            "address_purpose": "LOCATION",
            "city": "Forest Hills",
            "state": "NY",
            "postal_code": "113752029",
            "country_code": "US",
            "telephone_number": "718-830-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHIN-YOUNG",
        "first_name": "VICTORIA",
        "middle_name": "VINCELLA",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-10-31",
        "last_updated": "2021-12-21",
        "certification_date": "2021-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "604593-1",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN265573",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lilburn, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2021; 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.