Lisa Dyer Young, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

21253 Issued in AL

Practice address

2401 Village Professional Drive
Opelika, AL 36801-4702

Phone

(334) 749-8121

Fax

(334) 749-6166

NPI assigned

Feb 12, 2007

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 7

Other names 1

• Miss Lisa Dawn Dyer Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: lisayoung@pcllc.allscriptsdirect.net

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.

• Pediatric Clinic LLC

  • Pediatrics Physician
  • Opelika, AL
  • NPI 1134286248
  NPD (past)
• Pediatric Clinic LLC

  • Pediatrics Physician
  • Auburn, AL
  • NPI 1205977089
  NPD (past)
• Pediatric Clinic LLC

  • Pediatrics Physician
  • Auburn, AL
  • NPI 1588425953
  NPD (past)
• The East Alabama Health Care Authority

  • General Acute Care Hospital
  • Opelika, AL
  • NPI 1154386431
  NPD (past)

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1922149798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 VILLAGE PROFESSIONAL DRIVE",
            "city": "OPELIKA",
            "state": "AL",
            "postal_code": "368014702",
            "telephone_number": "334-749-8121",
            "fax_number": "334-749-6166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 VILLAGE PROFESSIONAL DRIVE",
            "city": "OPELIKA",
            "state": "AL",
            "postal_code": "368014702",
            "telephone_number": "334-749-8121",
            "fax_number": "334-749-6166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "LISA",
        "middle_name": "DYER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-12",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AL",
            "license": "21253",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ALABAMA CONTR SUBST CERT",
            "identifier": "21253",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICAN BOARD PEDIATRICS",
            "identifier": "36452",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS AL PROV # AUBURN",
            "identifier": "510-96615",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AAP ID",
            "identifier": "177521",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ALABAMA MEDICAL LICENSE",
            "identifier": "21253",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS AL PROV # OPELIKA",
            "identifier": "510-96612",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH PROV #",
            "identifier": "1210778",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "DYER",
            "middle_name": "DAWN",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Caroline Yeargan, CRNP
• Minsoo Yeo, DMD
• Kathy Yosten, LCSW
• Lakiesha Young Hicks, HAIR LOSS SPECIALIST
• Brian Clay Young, NURSE PRACTITIONER
• Marc T Young, PHARMD
• Sadie Smith Young
• Laura Zambrana
• Kiana Zanganeh, DO
• Luis F Zegada, M.D.

• Pediatrics Physician in Opelika, AL
• Providers in Opelika, AL by specialty
• Pediatrics Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.