Individual provider Active NPI

Wendi D Young, CRNA

  • Certified Registered Nurse Anesthetist
  • Mooresville, NC
National Provider Identifier
1760653570
Registry record updated Aug 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
6015 Issued in NC
Practice address
146 Medical Park Rd Ste 108
Mooresville, NC 28117-8529
Phone
(704) 662-0877
Fax
(046) 662-0875
NPI assigned
Mar 19, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 6015 NC Primary
Certified Registered Nurse Anesthetist 367500000X 308964 NC
Certified Registered Nurse Anesthetist 367500000X 9265693 FL

Addresses

Primary practice location

146 Medical Park Rd Ste 108
Mooresville, NC 28117-8529

Mailing address

146 Medical Park Rd Ste 108
Mooresville, NC 28117-8529
Phone (704) 662-0877

Other practice location 1

1 Tampa General Cir
Suite A327
Tampa, FL 33606-3571
Phone (813) 844-4434

Other identifiers 1

IdentifierTypeStateIssuer
890200HMedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190219000652 NC Practitioner - Certified Registered Nurse Anesthetist (Crna) 0648412031 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
9265693FLMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Allcare Clinical Associates PA Nurse Anesthetist, Certified Registered CurrentSince Dec 1, 2021 Accepting new patients
Gateway Anesthesia LLC Nurse Anesthetist, Certified Registered CurrentSince Nov 1, 2019 Accepting new patients
Allcare Clinical Associates, PA CurrentSince Dec 1, 2021 Accepting new patients
East Carolina Anesthesia Associates, PLLC Nurse Anesthetist, Certified Registered CurrentSince May 1, 2021 Accepting new patients
Providence Anesthesiology Associates, P.a. CurrentSince Aug 1, 2025 Accepting new patients
Alta Anesthesia Associates of Georgia, PC Nurse Anesthetist, Certified Registered PastSince Nov 11, 2012 Accepting new patients
Gulf-to-Bay Anesthesiology Associates LLC Past Accepting new patients

Locations

400 10th St E
Waconia, MN 55387

34 Granby St
Asheville, NC 28801
Phone (828) 225-0861

131 Providence Rd
Ste 200
Charlotte, NC 28207
Phone 70474958001101

2825 Randolph Rd
Charlotte, NC 28211
Phone (704) 377-1647

3621 Randolph Rd
Charlotte, NC 28211
Phone (704) 206-8800

1918 Randolph Rd
Ste 740
Charlotte, NC 28207
Phone (704) 316-0810

1025 NE Gateway Ct NE
Concord, NC 28025
Phone (704) 920-7020

2430 Emerald Pl
Ste 103
Greenville, NC 27834
Phone (252) 752-2140

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1205884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598227200000",
    "number": "1760653570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "146 MEDICAL PARK RD STE 108",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281178529",
            "telephone_number": "704-662-0877",
            "fax_number": "046-662-0875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "146 MEDICAL PARK RD STE 108",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281178529",
            "telephone_number": "704-662-0877",
            "fax_number": "046-662-0875"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Tampa General Cir",
            "address_2": "Suite A327",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336063571",
            "country_code": "US",
            "telephone_number": "813-844-4434",
            "fax_number": "813-844-4972",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "WENDI",
        "middle_name": "D",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-19",
        "last_updated": "2020-08-24",
        "certification_date": "2020-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NC",
            "license": "6015",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NC",
            "license": "308964",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "9265693",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890200H",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mooresville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2020; 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.

Verify at the official NPI Registry.