Tara Rose Young

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

4704257569 Issued in MI

Practice address

6444 Los Altos Dr NE
Rockford, MI 49341-8106

Phone

(616) 970-2888

NPI assigned

Sep 18, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• McLaren Central Michigan

  • General Acute Care Hospital
  • Mt Pleasant, MI
  • NPI 1245266063
  Medicare reassignment NPD
• McLaren Central Michigan

  • Family Medicine Physician
  • Mount Pleasant, MI
  • NPI 1710235775
  NPD
• McLaren Central Michigan

  • Rural Health Clinic/Center
  • Gladwin, MI
  • NPI 1841812989
  NPD
• McLaren Central Michigan

  • General Acute Care Hospital
  • Mt Pleasant, MI
  • NPI 1538195409
  NPD (past)

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

{
    "created_epoch": "1726617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726617600000",
    "number": "1851128201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6444 LOS ALTOS DR NE",
            "city": "ROCKFORD",
            "state": "MI",
            "postal_code": "493418106",
            "telephone_number": "616-970-2888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6444 LOS ALTOS DR NE",
            "city": "ROCKFORD",
            "state": "MI",
            "postal_code": "493418106",
            "telephone_number": "616-970-2888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "TARA",
        "middle_name": "ROSE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-18",
        "last_updated": "2024-09-18",
        "certification_date": "2024-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MI",
            "license": "4704257569",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anna Xiao, M.ED., BCBA
• Dulcie Yancharas, LMSW
• Caesy Lewis Yarling, D.O.
• Saithip Yongsatirachot-Tanner
• Michael McFarlane York, ATC
• Your Home Birth LLC
• Janelle Therese Zajac, PA-C
• Paul Ziedins, LMSW
• Ann E Ziel
• Kelly Marie Daugherty Zielaskowski, O.D.

• Pediatric Nurse Practitioner in Rockford, MI
• Providers in Rockford, MI by specialty
• Pediatric Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2024; 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.