Active NPI
Elaine M Young MD Inc
- Dermatology Physician
- Huntington, WV
National Provider Identifier
1699970335
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- 16077
- Legal business name
- ELAINE M YOUNG MD INC
- Practice address
- 1411 6TH Ave
Huntington, WV 25701 - Phone
- (304) 525-6132
- Fax
- (304) 697-0471
- NPI assigned
- Jun 20, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Elaine M Young, MD
- Title
- President
- Phone
- (304) 525-6132
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | 16077 | WV | Primary |
| Pediatric Dermatology Physician | 207NP0225X | 16077 | WV | |
| Procedural Dermatology Physician | 207NS0135X | 16077 | WV |
Addresses
Primary practice location
1411 6TH Ave
Huntington, WV 25701
Mailing address
1411 6TH Ave
Huntington, WV 25701
Phone (304) 525-6132
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0069955000 | Medicaid | WV | |
| 1376528356 | Other | PROVIDER NPI NUMBER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WV
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
1411 6th Ave
Huntington, WV 25701
Phone (304) 525-6132
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Dermatology Physician
- Huntington, WV
- NPI 1376528356
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1182297600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1211155200000",
"number": "1699970335",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1411 6TH AVE",
"city": "HUNTINGTON",
"state": "WV",
"postal_code": "25701",
"telephone_number": "304-525-6132",
"fax_number": "304-697-0471"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1411 6TH AVE",
"city": "HUNTINGTON",
"state": "WV",
"postal_code": "25701",
"telephone_number": "304-525-6132",
"fax_number": "304-697-0471"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ELAINE M YOUNG MD INC",
"organizational_subpart": "NO",
"enumeration_date": "2007-06-20",
"last_updated": "2008-05-19",
"status": "A",
"authorized_official_last_name": "YOUNG",
"authorized_official_first_name": "ELAINE",
"authorized_official_middle_name": "M",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "304-525-6132",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dermatology",
"state": "WV",
"license": "16077",
"primary": true
},
{
"code": "207NP0225X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dermatology, Pediatric Dermatology",
"state": "WV",
"license": "16077",
"primary": false
},
{
"code": "207NS0135X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dermatology, Procedural Dermatology",
"state": "WV",
"license": "16077",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0069955000",
"state": "WV"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PROVIDER NPI NUMBER",
"identifier": "1376528356",
"state": null
}
],
"endpoints": [],
"other_names": []
}
Other providers in Huntington, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.