NPIMap

Organization Active NPI

Kelly Young

  • Emergency Care Clinic/Center
  • Decatur, AL
National Provider Identifier
1760770770
Registry record updated Jul 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Care Clinic/CenterTaxonomy code 261QE0002X
License
1-117362 Issued in AL
Legal business name
KELLY YOUNG
Practice address
1874 Beltline Rd SW
Decatur, AL 35601-5514
Phone
(256) 350-2211
NPI assigned
Jul 12, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2011

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

Authorized official

Name
Kelly Young
Title
Sole Proprietor
Phone
(256) 426-0020

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Care Clinic/Center 261QE0002X 1-117362 AL Primary

Addresses

Primary practice location

1874 Beltline Rd SW
Decatur, AL 35601-5514

Mailing address

222 Brockton Dr
Madison, AL 35756-4048
Phone (256) 426-0020

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1310428800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1310428800000",
    "number": "1760770770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 BROCKTON DR",
            "city": "MADISON",
            "state": "AL",
            "postal_code": "357564048",
            "telephone_number": "256-426-0020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1874 BELTLINE RD SW",
            "city": "DECATUR",
            "state": "AL",
            "postal_code": "356015514",
            "telephone_number": "256-350-2211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KELLY YOUNG",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-12",
        "last_updated": "2011-07-12",
        "status": "A",
        "authorized_official_last_name": "YOUNG",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "SOLE PROPRIETOR",
        "authorized_official_telephone_number": "256-426-0020"
    },
    "taxonomies": [
        {
            "code": "261QE0002X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Emergency Care",
            "state": "AL",
            "license": "1-117362",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.