Perry Thomas Young Jr., MD

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

2500 N State St
Jackson, MS 39216-4500

Phone

(601) 815-1779

NPI assigned

Apr 4, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1554336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554336000000",
    "number": "1922560200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1428 WINCHESTER ST",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392115638",
            "telephone_number": "662-255-2863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 N STATE ST",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164500",
            "telephone_number": "601-815-1779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "PERRY",
        "middle_name": "THOMAS",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-04",
        "last_updated": "2019-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly Latasha Young
• Lashun A. Young, PH.D.
• Lisimba Young
• Marietta Grace Young
• Matthew Young
• Rochelle R Young, PMHNP-BC, FNP-C
• Roderick Alexander Young, A.T.C L.A.T.
• Tammy H Young, M.D.
• Tara Young, CMHT, LMSW
• Thomas Cole Young, M.D.

• Student in an Organized Health Care Education/Training Program in Jackson, MS
• Providers in Jackson, MS by specialty
• Student in an Organized Health Care Education/Training Program in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2019; 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.