Jared Michael Young, RN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

PN117377 Issued in OH

Practice address

6140 Simmons Church Rd
Centerburg, OH 43011-9418

Phone

(740) 504-0714

NPI assigned

Apr 4, 2011

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

Practice roles

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.

• Three Angels Home Health, LLC

  • Home Health Agency
  • Centerburg, OH
  • NPI 1386244671
  NPD Authorized official

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

{
    "created_epoch": "1301875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602201600000",
    "number": "1679862288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6140 SIMMONS CHURCH RD",
            "city": "CENTERBURG",
            "state": "OH",
            "postal_code": "430119418",
            "telephone_number": "740-504-0714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6140 SIMMONS CHURCH RD",
            "city": "CENTERBURG",
            "state": "OH",
            "postal_code": "430119418",
            "telephone_number": "740-504-0714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "JARED",
        "middle_name": "MICHAEL",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-04-04",
        "last_updated": "2020-10-09",
        "certification_date": "2020-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "PN117377",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Natalie K Trick, OTRL
• Erin Nicole-Deal Vieira, D.D.S.
• Julie Wandtke
• Madison Wright-Piekarski, DDS
• Amanda Jo Yaeger, RN

• Licensed Practical Nurse in Centerburg, OH
• Providers in Centerburg, OH by specialty
• Licensed Practical Nurse in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 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.