Individual provider Active NPI

Shawn Youngman, FNP

  • Family Nurse Practitioner
  • Johnson City, TN
National Provider Identifier
1831562016
Registry record updated Apr 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
20673 Issued in TN
Practice address
400 N State of Franklin Rd
Room 2746
Johnson City, TN 37604-6035
Phone
(423) 431-2727
Fax
(423) 431-6715
NPI assigned
Nov 10, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine Nurse Practitioner 363LC0200X 20673 TN
Family Nurse Practitioner 363LF0000X 20673 TN Primary

Addresses

Primary practice location

400 N State of Franklin Rd
Room 2746
Johnson City, TN 37604-6035

Mailing address

400 N State of Franklin Rd
Room 2746
Johnson City, TN 37604-6035
Phone (423) 431-2727

Other identifiers 2

IdentifierTypeStateIssuer
Q018961MedicaidTN
1831562016MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, VA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20160216002566 TN Practitioner - Nurse Practitioner 7315242161 Reassigns benefits to 2 organizations
I20221210000158 VA Practitioner - Nurse Practitioner 7315242161 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Blue Ridge Medical Management CorporationGroup PAC ID 9739099441, shared by 2 NPIs, 283 clinicians

Practice addresses (Care Compare)

16000 Johnston Memorial Dr
312D
Abingdon, VA 24211-7664
Phone (276) 258-1740

410 N State of Franklin Rd
Suite 135B
Johnson City, TN 37604-6972
Phone (423) 431-4866

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20673TNMDCritical Care Medicine Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Blue Ridge Medical Management Corporation CurrentSince Sep 2, 2022 Accepting new patients
Blue Ridge Medical Management Corporation Current Accepting new patients
Blue Ridge Medical Management Corporation CurrentSince Jan 1, 2025 Accepting new patients
Mountain Empire Radiology Inc PC CurrentSince Aug 23, 2023 Accepting new patients
Blue Ridge Medical Management Corporation Current Accepting new patients
Blue Ridge Medical Management Corporation CurrentSince Sep 2, 2022 Accepting new patients
Blue Ridge Medical Management Corporation Family Past Accepting new patients

Locations

1497 W Elk Ave
Ste 20
Elizabethton, TN 37643
Phone (423) 547-7380

100 Greenway Cir
Erwin, TN 37650
Phone (423) 743-1271

400 N State of Franklin Rd
Johnson City, TN 37604
Phone (423) 431-1310

410 N State of Franklin Rd
Ste 135B
Johnson City, TN 37604
Phone (423) 431-2477

1019 W Oakland Ave
Ste 1
Johnson City, TN 37604
Phone (423) 915-5000

400 N State of Franklin Rd
Rm 2746
Johnson City, TN 37604
Phone (423) 431-2727

2 Professional Park Dr
Ste 15
Johnson City, TN 37604
Phone (423) 232-4867

16000 Johnston Memorial Dr
#312D
Abingdon, VA 24211
Phone (276) 258-1740

323 Falls Dr NW
Abingdon, VA 24210
Phone (276) 628-2612

Organizations & group practices 7

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 4

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": "1447113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524096000000",
    "number": "1831562016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 N STATE OF FRANKLIN RD",
            "address_2": "ROOM 2746",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376046035",
            "telephone_number": "423-431-2727",
            "fax_number": "423-431-6715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 N STATE OF FRANKLIN RD",
            "address_2": "ROOM 2746",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376046035",
            "telephone_number": "423-431-2727",
            "fax_number": "423-431-6715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNGMAN",
        "first_name": "SHAWN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-10",
        "last_updated": "2018-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LC0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Critical Care Medicine",
            "state": "TN",
            "license": "20673",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "20673",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q018961",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1831562016",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, TN

Sources for this page

Verify at the official NPI Registry.