Active NPI
Stephanie Anne Young, R.D.N., L.D./C.D.
- Registered Dietitian
- Dubuque, IA
National Provider Identifier
1861805442
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 072496
- Practice address
- 1560 University Ave
Dubuque, IA 52001-4790 - Phone
- (563) 589-2324
- Fax
- (563) 557-2878
- NPI assigned
- Jun 11, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 072496 | IA | Primary |
Addresses
Primary practice location
1560 University Ave
Dubuque, IA 52001-4790
Mailing address
1560 University Ave
Dubuque, IA 52001-4790
Phone (563) 589-2324
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 072496 | Other | IA | STATE LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 072496 | IA | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1402444800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1402444800000",
"number": "1861805442",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1560 UNIVERSITY AVE",
"city": "DUBUQUE",
"state": "IA",
"postal_code": "520014790",
"telephone_number": "563-589-2324",
"fax_number": "563-557-2878"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1560 UNIVERSITY AVE",
"city": "DUBUQUE",
"state": "IA",
"postal_code": "520014790",
"telephone_number": "563-589-2324",
"fax_number": "563-557-2878"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YOUNG",
"first_name": "STEPHANIE",
"middle_name": "ANNE",
"name_prefix": "Mrs.",
"credential": "R.D.N., L.D./C.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-06-11",
"last_updated": "2014-06-11",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "IA",
"license": "072496",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "072496",
"state": "IA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Dubuque, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.