Active NPI
Samantha June Young, NP
- Nurse Practitioner
- Omaha, NE
National Provider Identifier
1861998270
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 2050
- Practice address
- 17021 Lakeside Drive
Suite 200
Omaha, NE 68130 - Phone
- (402) 592-9000
- Fax
- (402) 592-1631
- NPI assigned
- Apr 4, 2018
- 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 |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 2050 | NE | Primary |
Addresses
Primary practice location
17021 Lakeside Drive
Suite 200
Omaha, NE 68130
Mailing address
17021 Lakeside Drive
Suite 200
Omaha, NE 68130
Phone (402) 592-9000
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)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2050 | NE | MD | Medical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1522800000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1630454400000",
"number": "1861998270",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17021 LAKESIDE DRIVE",
"address_2": "SUITE 200",
"city": "OMAHA",
"state": "NE",
"postal_code": "68130",
"telephone_number": "402-592-9000",
"fax_number": "402-592-1631"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17021 LAKESIDE DRIVE",
"address_2": "SUITE 200",
"city": "OMAHA",
"state": "NE",
"postal_code": "68130",
"telephone_number": "402-592-9000",
"fax_number": "402-592-1631"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YOUNG",
"first_name": "SAMANTHA",
"middle_name": "JUNE",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-04-04",
"last_updated": "2021-09-01",
"certification_date": "2021-09-01",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "NE",
"license": "2050",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Omaha, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.