Active NPI
Elaine Youngman, CNS
- Clinical Nurse Specialist
- Raleigh, NC
National Provider Identifier
1720091333
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Nurse Specialist
- License
- 115567
- Practice address
- 3024 New Bern Ave
Suite 301 - Internal Medicine
Raleigh, NC 27610-1247 - Phone
- (919) 350-7993
- Fax
- (919) 350-7988
- NPI assigned
- Aug 14, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Clinical Nurse Specialist | 364S00000X | 115567 | NC | Primary |
Addresses
Primary practice location
3024 New Bern Ave
Suite 301 - Internal Medicine
Raleigh, NC 27610-1247
Mailing address
3024 New Bern Ave
Suite 300
Raleigh, NC 27610-1247
Phone (919) 350-8228
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6004015 | Medicaid | NC |
Other names 1
- Elaine Phetteplace
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
- Certified Nurse Specialist
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wakemed Faculty Practice Plan | Past | Accepting new patients | |
| Wake Specialty Physicians, LLC | Past | Accepting new patients | |
| Wakemed Faculty Practice Plan | Past | Accepting new patients |
Organizations & group practices 3
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.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155513600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1720091333",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3024 NEW BERN AVE",
"address_2": "SUITE 300",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276101247",
"telephone_number": "919-350-8228",
"fax_number": "919-350-7976"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3024 NEW BERN AVE",
"address_2": "SUITE 301 - INTERNAL MEDICINE",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276101247",
"telephone_number": "919-350-7993",
"fax_number": "919-350-7988"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YOUNGMAN",
"first_name": "ELAINE",
"name_prefix": "Ms.",
"credential": "CNS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-14",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "364S00000X",
"taxonomy_group": "",
"desc": "Clinical Nurse Specialist",
"state": "NC",
"license": "115567",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6004015",
"state": "NC"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "ELAINE",
"last_name": "PHETTEPLACE",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Raleigh, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.