Individual provider Active NPI

Caitlin C Young, NP

  • Family Nurse Practitioner
  • Pooler, GA
National Provider Identifier
1669989000
Registry record updated May 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN224811 Issued in GA
Practice address
101 St. Joseph'S Candler Drive
Suite 200
Pooler, GA 31322
Phone
(912) 748-1999
Fax
(912) 748-3847
NPI assigned
Jan 8, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 20, 2019

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 RN224811 GA Primary

Addresses

Primary practice location

101 St. Joseph'S Candler Drive
Suite 200
Pooler, GA 31322

Mailing address

836 E. 65TH Street
Suite 20
Savannah, GA 31405
Phone (912) 819-7878

Other practice location 1

105 Grand Central Blvd Ste 101
Pooler, GA 31322
Phone (912) 748-1999

Other identifiers 1

IdentifierTypeStateIssuer
003202780BMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20180918003699 GA Practitioner - Nurse Practitioner 8921359779 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
SJC Medical Group IncGroup PAC ID 7719978105, 57 clinicians
Effingham Rehab Services, LLCGroup PAC ID 5597752063, shared by 3 NPIs, 143 clinicians

Practice addresses (Care Compare)

11705 Mercy Blvd
Savannah, GA 31419-1711
Phone (912) 819-4949

123 Canal St
Suite 203
Pooler, GA 31322-4104
Phone (912) 988-1283

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
SJC Medical Group Inc CurrentSince Mar 1, 2018 Accepting new patients
Candler ENT Practice, LLC Past Accepting new patients
St. Joseph'S Cardiology Group, LLC Past Accepting new patients
Candler Medical Group, Inc. - Islands Past Accepting new patients

Locations

101 Saint Josephs Candler Dr
Ste 200
Pooler, GA 31322
Phone (912) 748-1999

105 Grand Central Blvd
Ste 101
Pooler, GA 31322
Phone (912) 244-3305

602 E 72nd St
Savannah, GA 31405
Phone (912) 819-7800

11705 Mercy Blvd
Savannah, GA 31419
Phone (912) 819-2452

Interoperability endpoints

  • Direct secure messaging: youngcat@direct.sjchs.org

Organizations & group practices 4

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1515369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558310400000",
    "number": "1669989000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "836 E. 65TH STREET",
            "address_2": "SUITE 20",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "31405",
            "telephone_number": "912-819-7878",
            "fax_number": "912-819-3555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 ST. JOSEPH'S CANDLER DRIVE",
            "address_2": "SUITE 200",
            "city": "POOLER",
            "state": "GA",
            "postal_code": "31322",
            "telephone_number": "912-748-1999",
            "fax_number": "912-748-3847"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "105 Grand Central Blvd Ste 101",
            "address_purpose": "LOCATION",
            "city": "Pooler",
            "state": "GA",
            "postal_code": "31322",
            "country_code": "US",
            "telephone_number": "912-748-1999",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "CAITLIN",
        "middle_name": "C",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-01-08",
        "last_updated": "2019-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN224811",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003202780B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pooler, GA

Sources for this page

Verify at the official NPI Registry.