Active NPI
Lon Kendall Young, MD
- Emergency Medical Services (Emergency Medicine) Physician
- Bryan, TX
National Provider Identifier
1952356669
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medical Services (Emergency Medicine) Physician
- License
- L9566
- Practice address
- 3134 Briarcrest Dr
Bryan, TX 77802-3014 - Phone
- (979) 314-2323
- NPI assigned
- May 23, 2006
- Last updated
- Jun 3, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 167074703 | Medicaid | TX |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040826000590 | TX | Practitioner - Emergency Medicine | 7517932346 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| L9566 | TX | MD | Emergency Medical Services (Emergency Medicine) Physician |
Practice roles
| Organization | Specialty | Status | New 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.
-
- Emergency Medicine Physician
- Bryan, TX
- NPI 1922409101
-
dba CapRock 24 Hour Emergency
- Emergency Care Clinic/Center
- College Station, TX
- NPI 1386045185
-
dba Caprock Hospital
- General Acute Care Hospital
- Bryan, TX
- NPI 1770099392
-
- Emergency Medical Services (Emergency Medicine) Physician
- Corsicana, TX
- NPI 1962696013
-
- Emergency Medicine Physician
- Navasota, TX
- NPI 1982642955
-
- Emergency Medicine Physician
- Bryan, TX
- NPI 1417995481
-
- Emergency Medicine Physician
- Bryan, TX
- NPI 1447447230
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2024; 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.