Individual provider Active NPI

Melanie S Young, FNP

  • Family Nurse Practitioner
  • Baxley, GA
National Provider Identifier
1679855134
Registry record updated Jan 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN113728 Issued in GA
Practice address
105 E Tollison St
Suite D
Baxley, GA 31513-0149
Phone
(912) 366-9688
Fax
(912) 366-9888
NPI assigned
Sep 12, 2011
Last updated
Jan 15, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2020

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 RN113728 GA Primary

Addresses

Primary practice location

105 E Tollison St
Suite D
Baxley, GA 31513-0149

Mailing address

PO Box 2070
Baxley, GA 31515-2070
Phone (912) 367-9841

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)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN113728GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Appalachian Home Health Care, Inc. Current Accepting new patients
The Baxley and Appling County Hospital Authority Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: melanie.young@ahcs.eclinicaldirectplus.com
  • Direct secure messaging: melanie.young@ahcs.gadirect.net

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1315785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579046400000",
    "number": "1679855134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2070",
            "city": "BAXLEY",
            "state": "GA",
            "postal_code": "315152070",
            "telephone_number": "912-367-9841",
            "fax_number": "912-367-7203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 E TOLLISON ST",
            "address_2": "SUITE D",
            "city": "BAXLEY",
            "state": "GA",
            "postal_code": "315130149",
            "telephone_number": "912-366-9688",
            "fax_number": "912-366-9888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "MELANIE",
        "middle_name": "S",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-12",
        "last_updated": "2020-01-15",
        "certification_date": "2020-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN113728",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baxley, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2020; 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.