Active NPI
James E Young, M.D.
- Specialist
- Grand Rapids, MI
National Provider Identifier
1700842010
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 4301063990
- Practice address
- 3230 Eagle Park Dr NE
Suite 100
Grand Rapids, MI 49525-4047 - Phone
- (616) 988-2229
- Fax
- (616) 988-2010
- NPI assigned
- Apr 25, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 4301063990 | MI | Primary |
Addresses
Primary practice location
3230 Eagle Park Dr NE
Suite 100
Grand Rapids, MI 49525-4047
Mailing address
3230 Eagle Park Dr NE
Suite 100
Grand Rapids, MI 49525-4047
Phone (616) 988-2229
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3053465 | Medicaid | MI |
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
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4301063990 | MI | MD | Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Frederick Health Hospital Inc | Past | 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.
-
- General Acute Care Hospital
- Frederick, MD
- NPI 1538165527
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1145923200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1216080000000",
"number": "1700842010",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3230 EAGLE PARK DR NE",
"address_2": "SUITE 100",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495254047",
"telephone_number": "616-988-2229",
"fax_number": "616-988-2010"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3230 EAGLE PARK DR NE",
"address_2": "SUITE 100",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495254047",
"telephone_number": "616-988-2229",
"fax_number": "616-988-2010"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YOUNG",
"first_name": "JAMES",
"middle_name": "E",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-25",
"last_updated": "2008-07-15",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "MI",
"license": "4301063990",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3053465",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Grand Rapids, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.