Organization Active NPI

Young Chiropractic & Acupuncture, LTD.

  • Chiropractor
  • Champaign, IL
National Provider Identifier
1891232153
Registry record updated Mar 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038.012380 Issued in NU
Legal business name
YOUNG CHIROPRACTIC & ACUPUNCTURE, LTD.
Practice address
2911 Crossing Court
Suite 101
Champaign, IL 61822-6108
Phone
(217) 359-0550
Fax
(217) 359-0808
NPI assigned
Jan 25, 2017
Last updated
Mar 1, 2018By the provider in NPPES
Organization subpart
Yes
Parent organization
YOUNG CHIROPRACTIC & ACUPUNCTURE, LTDAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 1, 2018

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

Authorized official

Name
Dr. Kassie Jean Young, D.C.NPI 1114260452
Title
Business Owner
Phone
(217) 359-0550

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038.012380 IL
Chiropractor 111N00000X 038.012380 NU Primary

Addresses

Primary practice location

2911 Crossing Court
Suite 101
Champaign, IL 61822-6108

Mailing address

2911 Crossing Court
Suite 101
Champaign, IL 61822-6108
Phone (217) 359-0550

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170316002023 IL Part B Supplier - Clinic/Group Practice 0446535215 Receives reassigned benefits from 1 practitioner
Practice locations: Champaign, IL

National Provider Directory

National Provider Directory
Part of
Young Chiro Acupuncture

Locations

1712 S Duncan Rd
Ste B
Champaign, IL 61822
Phone (217) 359-6625

2911 Crossing Ct
Ste 101
Champaign, IL 61822
Phone (217) 359-0550

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1485302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1519862400000",
    "number": "1891232153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2911 CROSSING COURT",
            "address_2": "SUITE 101",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618226108",
            "telephone_number": "217-359-0550",
            "fax_number": "217-359-0808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2911 CROSSING COURT",
            "address_2": "SUITE 101",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618226108",
            "telephone_number": "217-359-0550",
            "fax_number": "217-359-0808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YOUNG CHIROPRACTIC & ACUPUNCTURE, LTD.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "YOUNG CHIROPRACTIC & ACUPUNCTURE, LTD",
        "enumeration_date": "2017-01-25",
        "last_updated": "2018-03-01",
        "status": "A",
        "authorized_official_last_name": "YOUNG",
        "authorized_official_first_name": "KASSIE",
        "authorized_official_middle_name": "JEAN",
        "authorized_official_title_or_position": "BUSINESS OWNER",
        "authorized_official_telephone_number": "217-359-0550",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038.012380",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NU",
            "license": "038.012380",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Champaign, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.