Individual provider Active NPI

Lon Kendall Young, MD

  • Emergency Medical Services (Emergency Medicine) Physician
  • Bryan, TX
National Provider Identifier
1952356669
Registry record updated Jun 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X
License
L9566 Issued in TX
Practice address
3134 Briarcrest Dr
Bryan, TX 77802-3014
Phone
(979) 314-2323
NPI assigned
May 23, 2006
Last updated
Jun 3, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X L9566 TX Primary

Addresses

Primary practice location

3134 Briarcrest Dr
Bryan, TX 77802-3014

Mailing address

4711 Westminster Dr
Bryan, TX 77802-5912

Other identifiers 1

IdentifierTypeStateIssuer
167074703MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040826000590 TX Practitioner - Emergency Medicine 7517932346

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
L9566TXMDEmergency Medical Services (Emergency Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Brazos Valley Hospital, LLC Current Accepting new patients
Brazos Valley Hospital, LLC Current Accepting new patients
Bryan Emergency Physicians PA Past Accepting new patients
Emergency Physicians of Park Hudson PLLC Past Accepting new patients
Affilion of Texas PLLC Emergency Medical Services Past Accepting new patients
Brazos Valley Emergency Physicians PA Past Accepting new patients

Locations

3134 Briarcrest Dr
Bryan, TX 77802
Phone (979) 314-1105

3134 Briarcrest Dr
#P
Bryan, TX 77802
Phone (979) 314-1105

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717372800000",
    "number": "1952356669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4711 WESTMINSTER DR",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778025912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3134 BRIARCREST DR",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778023014",
            "telephone_number": "979-314-2323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "LON",
        "middle_name": "KENDALL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-23",
        "last_updated": "2024-06-03",
        "certification_date": "2024-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "TX",
            "license": "L9566",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "167074703",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bryan, TX

Sources for this page

Verify at the official NPI Registry.