Samuel Doak Young III, MD

Primary specialty

Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X

License

ME96716 Issued in FL

Practice address

2080 Child St
Jacksonville, FL 32214-5005

Phone

(904) 542-7679

NPI assigned

Aug 22, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 4

Other names 1

• Samuel D Young III Other name

Medicare fee-for-service enrollment

Enrolled in VA, NC2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Albemarle Physician Services - Sentara, Inc

  • Family Medicine Physician
  • Norfolk, VA
  • NPI 1942443130

  NC, Orthopaedic Surgery

  Medicare reassignment NPD
• Dominion Health Medical Assoc.

  • Ambulatory Surgical Clinic/Center
  • South Boston, VA
  • NPI 1255771770
  Medicare reassignment NPD
• RMH Medical Group LLC

  • General Practice Physician
  • Rockingham, VA
  • NPI 1669844908
  Medicare reassignment NPD
• Albemarle Physician Services - Sentara, Inc

  • Urgent Care Clinic/Center
  • Kitty Hawk, NC
  • NPI 1306202627
  NPD
• Dominion Health Medical Assoc

  • Cardiovascular Disease Physician
  • South Boston, VA
  • NPI 1356138879
  NPD
• Dominion Health Medical Assoc.

  • Orthopaedic Surgery Physician
  • South Boston, VA
  • NPI 1306150545
  NPD
• RMH Medical Group LLC

  • Customized Equipment (DME)
  • Harrisonburg, VA
  • NPI 1043238967
  NPD
• Lifelink Healthcare Institute Inc

  • Transplant Surgery Physician
  • Tampa, FL
  • NPI 1093732786
  NPD (past)

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

{
    "created_epoch": "1156204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694995200000",
    "number": "1811003593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2080 CHILD ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322145005",
            "telephone_number": "904-542-7679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2080 CHILD ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322145005",
            "telephone_number": "904-542-7679"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "620 John Paul Jones Cir",
            "address_purpose": "LOCATION",
            "city": "Portsmouth",
            "state": "VA",
            "postal_code": "237082111",
            "country_code": "US",
            "telephone_number": "757-953-5000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2509 Pleasant Run Dr",
            "address_purpose": "LOCATION",
            "city": "Harrisonburg",
            "state": "VA",
            "postal_code": "228018720",
            "country_code": "US",
            "telephone_number": "540-689-5500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1144 N Road St Ste 100",
            "address_purpose": "LOCATION",
            "city": "Elizabeth City",
            "state": "NC",
            "postal_code": "279093473",
            "country_code": "US",
            "telephone_number": "252-384-2360",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "422 Hamilton Blvd",
            "address_purpose": "LOCATION",
            "city": "South Boston",
            "state": "VA",
            "postal_code": "245925200",
            "country_code": "US",
            "telephone_number": "434-572-4074",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "SAMUEL",
        "middle_name": "DOAK",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-22",
        "last_updated": "2023-09-18",
        "certification_date": "2023-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "FL",
            "license": "ME96716",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "VA",
            "license": "0101240022",
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "FL",
            "license": "ME96716",
            "primary": true
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NC",
            "license": "2005-00921",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2762374-00",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "813042151A",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NC1999",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1811003593",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SAMUEL",
            "last_name": "YOUNG",
            "middle_name": "D",
            "suffix": "III",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Megan Boyle Young
• Naima Young
• Parker W Young, DO
• Patricia E Young, P.A-C
• Porter Young, MD
• Sean Young, DDS
• Shannon Elisa Young, DPT
• Sonya Young
• Susan Nilette Young, PSY. D.
• Sydney Alexis Young, DC

• Sports Medicine (Orthopaedic Surgery) Physician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Sports Medicine (Orthopaedic Surgery) Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.