Roger Young, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

041255812 Issued in IL

Practice address

1250 W Whittaker St
Salem, IL 62881-1917

Phone

(618) 548-3740

Fax

(618) 548-3705

NPI assigned

Oct 7, 2005

Last updated

Oct 16, 2013By the provider in NPPES

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

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 1980

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Salem Township HospitalGroup PAC ID 0840195277, 26 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Salem Township Hospital Hospital, Salem, IL, CCN 141345

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Salem Township Hospital

  • Critical Access Hospital
  • Salem, IL
  • NPI 1295739548
  Medicare reassignment Care Compare group NPD
• Salem Township Hospital

  dba STH Family Health Care Center

  • Rural Health Clinic/Center
  • Salem, IL
  • NPI 1649830472
  NPD
• Salem Township Hospital

  dba STH Rural Health Clinic

  • Rural Health Clinic/Center
  • Salem, IL
  • NPI 1265467195
  NPD (past)
• Salem Township Hospital

  • Critical Access Hospital
  • Salem, IL
  • NPI 1689732463
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Salem Township Hospital

  • Critical Access Hospital
  • Salem, IL
  • NPI 1295739548
  Care Compare affiliation

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

{
    "created_epoch": "1128643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1381881600000",
    "number": "1952399511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 W WHITTAKER ST",
            "city": "SALEM",
            "state": "IL",
            "postal_code": "628811917",
            "telephone_number": "618-548-3740",
            "fax_number": "618-548-3705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 W WHITTAKER ST",
            "city": "SALEM",
            "state": "IL",
            "postal_code": "628811917",
            "telephone_number": "618-548-3740",
            "fax_number": "618-548-3705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "ROGER",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-07",
        "last_updated": "2013-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "041255812",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE NUMBER",
            "identifier": "500025714",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GRP MEDICARE NUMBER",
            "identifier": "208959",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GRP MEDICARE NUMBER",
            "identifier": "207988",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE GROUP NUMBER",
            "identifier": "CJ2166",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "110230526",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eric Paul Williams, DC CCSP
• Wendy Marie Wilton, MS, CCC-SLP
• Elizabeth Wolff, O.D.
• Alexa Wurm, PMHNP-BC
• Leslie Yates
• Mahvish Zahoor, MD
• Nancy Zutshi, M.D.

• Nurse Practitioner in Salem, IL
• Providers in Salem, IL by specialty
• Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2013; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.