Individual provider Active NPI

Jennifer Nancy Young, M.D.

  • Internal Medicine Physician
  • Coral Gables, FL
National Provider Identifier
1801076732
Registry record updated Aug 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME 125964 Issued in FL
Practice address
4100 Salzedo St Ste 4
Coral Gables, FL 33146-1751
Phone
(786) 227-6811
NPI assigned
Nov 8, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 21, 2023

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

Specialties & licenses 14

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X T0677 TX
Internal Medicine Physician 207R00000X 0101274089 VA
Internal Medicine Physician 207R00000X 87445 SC
Internal Medicine Physician 207R00000X 01087564A IN
Internal Medicine Physician 207R00000X 2022-01645 NC
Internal Medicine Physician 207R00000X 2022007449 MO
Internal Medicine Physician 207R00000X MD202494 OR
Internal Medicine Physician 207R00000X 68642 MN
Internal Medicine Physician 207R00000X MD61126080 WA
Internal Medicine Physician 207R00000X A96715 CA
Internal Medicine Physician 207R00000X 74858-20 WI
Internal Medicine Physician 207R00000X 291431 MA
Internal Medicine Physician 207R00000X DR.0065680 CO
Internal Medicine Physician 207R00000X ME 125964 FL Primary

Addresses

Primary practice location

4100 Salzedo St Ste 4
Coral Gables, FL 33146-1751

Mailing address

4100 Salzedo St Ste 4
Coral Gables, FL 33146-1751
Phone (786) 227-6811

Other names 1

  • Jennifer Nancy Heffernan Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A96715CAMDInternal Medicine Physician
DR.0065680COMDInternal Medicine Physician
ME 125964FLMDInternal Medicine Physician
01087564AINMDInternal Medicine Physician
291431MAMDInternal Medicine Physician
68642MNMDInternal Medicine Physician
2022007449MOMDInternal Medicine Physician
2022-01645NCMDInternal Medicine Physician
MD202494ORMDInternal Medicine Physician
87445SCMDInternal Medicine Physician
T0677TXMDInternal Medicine Physician
0101274089VAMDInternal Medicine Physician
MD61126080WAMDInternal Medicine Physician
74858-20WIMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1194480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692576000000",
    "number": "1801076732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4100 SALZEDO ST STE 4",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "331461751",
            "telephone_number": "786-227-6811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 SALZEDO ST STE 4",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "331461751",
            "telephone_number": "786-227-6811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "JENNIFER",
        "middle_name": "NANCY",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-11-08",
        "last_updated": "2023-08-21",
        "certification_date": "2023-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "T0677",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101274089",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": "87445",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "01087564A",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "2022-01645",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2022007449",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "MD202494",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MN",
            "license": "68642",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD61126080",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A96715",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "74858-20",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "291431",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CO",
            "license": "DR.0065680",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME 125964",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "HEFFERNAN",
            "middle_name": "NANCY",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Coral Gables, FL

Sources for this page

Verify at the official NPI Registry.