Individual provider Active NPI

Genesis Young

  • Family Nurse Practitioner
  • Louisville, KY
National Provider Identifier
1760851422
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3009640 Issued in KY
Practice address
9200 Shelbyville Rd Ste 530
Louisville, KY 40222-5144
Phone
(502) 327-9100
Fax
(855) 632-8329
NPI assigned
Sep 23, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 3009640 KY Primary

Addresses

Primary practice location

9200 Shelbyville Rd Ste 530
Louisville, KY 40222-5144

Mailing address

9200 Shelbyville Rd Ste 530
Louisville, KY 40222-5144
Phone (502) 327-9100

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151014002674 KY Practitioner - Nurse Practitioner 2264741222 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3009640KYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
HMV Diagnostics CurrentSince Mar 10, 2022 Accepting new patients

Locations

5304 Mile Stretch Dr
Holiday, FL 34690
Phone (727) 940-5908

1040 Monarch St
#330
Lexington, KY 40513
Phone 8772021191 ext. 313

1040 Monarch St
Ste 330
Lexington, KY 40513
Phone 8772021191 ext. 313

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.

NPI Registry JSON

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

{
    "created_epoch": "1442966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1760851422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9200 SHELBYVILLE RD STE 530",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402225144",
            "telephone_number": "502-327-9100",
            "fax_number": "855-632-8329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9200 SHELBYVILLE RD STE 530",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402225144",
            "telephone_number": "502-327-9100",
            "fax_number": "855-632-8329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "GENESIS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-23",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3009640",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.