Individual provider Active NPI

John Christopher Young, PH.D.

  • Clinical Neuropsychologist
  • Chattanooga, TN
National Provider Identifier
1740541333
Registry record updated May 31, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
3047 Issued in TN
Practice address
1 Siskin PLZ
Chattanooga, TN 37403-1306
Phone
(423) 634-1200
Fax
(423) 634-4550
NPI assigned
May 31, 2012
Last updated
May 31, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 31, 2012

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 3047 TN Primary
Clinical Psychologist 103TC0700X 3047 TN
Forensic Psychologist 103TF0200X 3047 TN
Health Service Psychologist 103TH0100X 3047 TN
Rehabilitation Psychologist 103TR0400X 3047 TN

Addresses

Primary practice location

1 Siskin PLZ
Chattanooga, TN 37403-1306

Mailing address

1 Siskin PLZ
Chattanooga, TN 37403-1306
Phone (423) 634-1200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120815000500 TN Practitioner - Clinical Psychologist 8325294846 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Chattanooga Hamilton County Hospital Authority CurrentSince Apr 1, 2015 Accepting new patients
Chattanooga Hamilton County Hospital Authority CurrentSince Apr 1, 2015 Accepting new patients
Siskin Hospital for Physical Rehabilitation CurrentSince Aug 15, 2012 Accepting new patients

Locations

1 Siskin Plz
Chattanooga, TN 37403
Phone (423) 634-1200

975 E 3rd St
Chattanooga, TN 37403
Phone (423) 266-1499

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, 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": "1338422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1338422400000",
    "number": "1740541333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 SISKIN PLZ",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374031306",
            "telephone_number": "423-634-1200",
            "fax_number": "423-634-4550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 SISKIN PLZ",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374031306",
            "telephone_number": "423-634-1200",
            "fax_number": "423-634-4550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "JOHN",
        "middle_name": "CHRISTOPHER",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-05-31",
        "last_updated": "2012-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "TN",
            "license": "3047",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TN",
            "license": "3047",
            "primary": false
        },
        {
            "code": "103TF0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Forensic",
            "state": "TN",
            "license": "3047",
            "primary": false
        },
        {
            "code": "103TH0100X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health Service",
            "state": "TN",
            "license": "3047",
            "primary": false
        },
        {
            "code": "103TR0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Rehabilitation",
            "state": "TN",
            "license": "3047",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chattanooga, TN

Sources for this page

Verify at the official NPI Registry.