Constance L Young, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

076265 Issued in MO

Practice address

527 Benham St
Bonne Terre, MO 63628-1205

Phone

(573) 358-9119

Fax

(573) 358-9489

NPI assigned

Feb 2, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MO

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

Practice roles

Interoperability endpoints

• Direct secure messaging: constance.young.p1@direct.wcmh-clinics.nextgenshare.com

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.

• Primary Care of Bonne Terre LLC

  • General Practice Physician
  • Bonne Terre, MO
  • NPI 1962883751
  Medicare reassignment
• Washington County Memorial Hospital

  • Critical Access Hospital
  • Potosi, MO
  • NPI 1194838821
  Medicare reassignment
• Washington County Memorial Hospital

  • Rural Health Clinic/Center
  • Potosi, MO
  • NPI 1467424788
  NPD (past)

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

{
    "created_epoch": "1138838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435536000000",
    "number": "1891767125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "527 BENHAM ST",
            "city": "BONNE TERRE",
            "state": "MO",
            "postal_code": "636281205",
            "telephone_number": "573-358-9119",
            "fax_number": "573-358-9489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "527 BENHAM ST",
            "city": "BONNE TERRE",
            "state": "MO",
            "postal_code": "636281205",
            "telephone_number": "573-358-9119",
            "fax_number": "573-358-9489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "CONSTANCE",
        "middle_name": "L",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-02",
        "last_updated": "2015-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "076265",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "428318000",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nancy Wey, RPH
• Bradley Michael White
• Mary L. Wilkerson Brabham, P.T.
• Nicole L Williams, CPHT
• Mandy Ann Yates
• Catherine Ann Zakibe, COTA
• Charlotta P Zimmerman
• Angela D Zolman, M.S. BCBA, LBA

• Family Nurse Practitioner in Bonne Terre, MO
• Providers in Bonne Terre, MO by specialty
• Family Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2015; 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.