Individual provider Active NPI

Tanya Marie Young, AGACNP-BC

  • Acute Care Nurse Practitioner
  • Canton, OH
National Provider Identifier
1982118824
Registry record updated Nov 30, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
APRN.CNP.021795 Issued in OH
Practice address
2600 Sixth St SW
Canton, OH 44710-1702
Phone
(330) 363-9970
NPI assigned
Nov 30, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X APRN.CNP.021795 OH Primary

Addresses

Primary practice location

2600 Sixth St SW
Canton, OH 44710-1702

Mailing address

4715 Hurless Dr SW
Canton, OH 44706-3815
Phone (330) 484-5077

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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

Enrollment IDStateProvider typePAC IDDetails
I20200218002951 OH Practitioner - Nurse Practitioner 2567899263 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aultman HospitalGroup PAC ID 3779485867, 41 clinicians

Practice addresses (Care Compare)

2600 6TH St SW
Canton, OH 44710-1702
Phone (330) 452-9911

Hospital & facility affiliations

  • Aultman Hospital Hospital, Canton, OH, CCN 360084

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN.CNP.021795OHMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Aultman Hospital CurrentSince Dec 11, 2019 Accepting new patients
Aultman Hospital CurrentSince Dec 11, 2019 Accepting new patients

Locations

2600 6th St SW
Canton, OH 44710
Phone (330) 363-2180

Organizations & group practices 2

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1512000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512000000000",
    "number": "1982118824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4715 HURLESS DR SW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447063815",
            "telephone_number": "330-484-5077",
            "fax_number": "330-484-5077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 SIXTH ST SW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447101702",
            "telephone_number": "330-363-9970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "TANYA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "AGACNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-30",
        "last_updated": "2017-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "OH",
            "license": "APRN.CNP.021795",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, OH

Sources for this page

Verify at the official NPI Registry.