Susan N Young Inc

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

PY7306 Issued in FL

Legal business name

SUSAN N YOUNG INC

Practice address

13400 Sutton Park Dr S
Suite 1504
Jacksonville, FL 32224-0236

Phone

(904) 223-6414

Fax

(904) 223-6418

NPI assigned

Jun 15, 2007

Last updated

Oct 17, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Susan N Young, PSY. D.NPI 1215039656

Title

Owner

Phone

(904) 223-6414

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Susan Nilette Young, PSY. D.

  • Clinical Neuropsychologist
  • Jacksonville, FL
  • NPI 1215039656
  Medicare reassignment NPD Authorized official
• Roger Davis, PH.D.

  • Psychologist
  • Jacksonville, FL
  • NPI 1174604987
  NPD (past)

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

{
    "created_epoch": "1181865600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1318809600000",
    "number": "1770788390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13400 SUTTON PARK DR S",
            "address_2": "SUITE 1504",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322240236",
            "telephone_number": "904-223-6414",
            "fax_number": "904-223-6418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13400 SUTTON PARK DR S",
            "address_2": "SUITE 1504",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322240236",
            "telephone_number": "904-223-6414",
            "fax_number": "904-223-6418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUSAN N YOUNG INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-15",
        "last_updated": "2011-10-17",
        "status": "A",
        "authorized_official_last_name": "YOUNG",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-223-6414",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY. D."
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "FL",
            "license": "PY7306",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "AF756",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Surrounding Circle of Care LLC
• Surrounding With Care
• Anil G Suryaprasad, MD
• Ihor Ihorovych Susak
• Susan C Williams,PHD,PA
• Susan Prater Kudlats, D.M.D, P.a. (Kernan Family Dental Care)
• Susan W Manchester (Manchester Medical Billing)
• Andrew Jeremiah Suslak, PHARMD, JD
• Craig Bradley Sussman, M.D.
• Kristin M Suter

• Clinical Neuropsychologist in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Clinical Neuropsychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2011; 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.