Individual provider Active NPI

Kimberly M Young, FNP-BC

  • Family Nurse Practitioner
  • Decatur, AL
National Provider Identifier
1811068133
Registry record updated May 27, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1-098727 Issued in AL
Practice address
1813 Beltline Rd SW
Decatur, AL 35601-5506
Phone
(256) 353-3500
Fax
(256) 353-6876
NPI assigned
Nov 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2008

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 1-098727 AL Primary

Addresses

Primary practice location

1813 Beltline Rd SW
Decatur, AL 35601-5506

Mailing address

1813 Beltline Rd SW
Decatur, AL 35601-5506
Phone (256) 353-3500

Other names 1

  • Miss Kimberly M Shossner Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20080206000491 AL Practitioner - Nurse Practitioner 3577668227 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Family Medicine Associates, PCGroup PAC ID 8224004437, 4 clinicians

Practice addresses (Care Compare)

1813 Beltline Rd SW
Decatur, AL 35601-5506
Phone (256) 353-3500

Hospital & facility affiliations

  • Decatur Morgan Hospital - Decatur Campus Hospital, Decatur, AL, CCN 010085

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1-098727ALMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Family Medicine Associates, PC CurrentSince Dec 17, 2007 Accepting new patients
First Care Medical Center PC Past Accepting new patients
Deborah Verbeek PastSince Jan 7, 2014 Accepting new patients
East Tennessee Surgical Group, P.C. PastSince Jan 1, 1994 Accepting new patients

Locations

1813 Beltline Rd SW
Decatur, AL 35601
Phone (256) 353-3500

Interoperability endpoints

  • Direct secure messaging: kimberly.young@ro.direct.systemedx.com
  • Direct secure messaging: kimberly.young.1@19222.direct.athenahealth.com

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1163116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211846400000",
    "number": "1811068133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1813 BELTLINE RD SW",
            "city": "DECATUR",
            "state": "AL",
            "postal_code": "356015506",
            "telephone_number": "256-353-3500",
            "fax_number": "256-353-6876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1813 BELTLINE RD SW",
            "city": "DECATUR",
            "state": "AL",
            "postal_code": "356015506",
            "telephone_number": "256-353-3500",
            "fax_number": "256-353-6876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "KIMBERLY",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-10",
        "last_updated": "2008-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-098727",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "SHOSSNER",
            "middle_name": "M",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Decatur, AL

Sources for this page

Verify at the official NPI Registry.