Organization Active NPI

Dr. Lee Youngworth, D.P.M., P.a., Inc

  • Podiatrist
  • Baltimore, MD
National Provider Identifier
1902340789
Registry record updated Dec 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
00897 Issued in MD
Legal business name
DR. LEE YOUNGWORTH, D.P.M., P.A., INC
Practice address
6611 Baythorne Rd
Baltimore, MD 21209-2605
Phone
(410) 484-8003
NPI assigned
Dec 13, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2016

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

Authorized official

Name
Dr. Lee Youngworth, D.P.M.NPI 1447215835
Title
President
Phone
(410) 484-8003

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X 00897 MD Primary

Addresses

Primary practice location

6611 Baythorne Rd
Baltimore, MD 21209-2605

Mailing address

6611 Baythorne Rd
Baltimore, MD 21209-2605
Phone (410) 484-8003

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170322002213 MD Part B Supplier - Clinic/Group Practice 1052696671 Receives reassigned benefits from 1 practitioner
Practice locations: Baltimore, MD

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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": "1481587200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1481587200000",
    "number": "1902340789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6611 BAYTHORNE RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212092605",
            "telephone_number": "410-484-8003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6611 BAYTHORNE RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212092605",
            "telephone_number": "410-484-8003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. LEE YOUNGWORTH, D.P.M., P.A., INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-13",
        "last_updated": "2016-12-13",
        "status": "A",
        "authorized_official_last_name": "YOUNGWORTH",
        "authorized_official_first_name": "LEE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "410-484-8003",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.P.M."
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "MD",
            "license": "00897",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2016; 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.