COLLEEN J YOUNG (NPI# 1104296805) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104296805 |
| Entity Type | Individual |
| Full Name | COLLEEN J YOUNG |
| Credential | PA-C |
| Practice Address |
1861 N Rock Rd Suite 310 Wichita KS 67206-4200 |
| Mailing Address |
1861 N Rock Road Suite 310 Wichita KS 67206-1264 |
| Practice Telephone | 3166121833 |
| Practice Fax Number | 3166122420 |
| Mailing Telephone | 3166121833 |
| Mailing Fax Number | 3166122420 |
| Enumeration Date | 2015-10-07 |
| Last Update Date | 2015-10-07 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
15-01820 | KS | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306296611 | Colleen Young | Registered Nurse | 2050 Pittston Farm Rd, Lithonia, GA 30058-5088 | 2016-06-16 |
| 1730556374 | Colleen Janel Young | Nurse Practitioner | 1885 West Henderson Rd, Upper Arlington, OH 43220-2501 | 2015-08-31 |
| 1265838528 | Colleen H Young | Massage Therapist | 9 Corporate Drive, Suite 3, Clifton Park, NY 12065 | 2014-11-14 |
| 1932440302 | Colleen Demi Young | Marriage & Family Therapist | 5053 La Mart Dr Ste 105, Riverside, CA 92507-5993 | 2013-03-11 |
| 1336385897 | Colleen Anne Young | Counselor | 2622 Mccarver St., Tacoma, WA 98403 | 2009-01-05 |
| 1053862458 | Colleen A. Young | Counselor | 776 Mountain Blvd, Suite 106, Watchung, NJ 07069-6269 | 2016-10-20 |
| 1851753289 | Colleen Baxter Young | Speech-Language Pathologist | 541 S Red Haven Ln, Dover, DE 19901-6483 | 2016-03-24 |
| 1053701441 | Colleen Young | Registered Nurse | 1080 N Delaware Ave Ste 300d, Philadelphia, PA 19125-4335 | 2015-01-23 |
| 1326271065 | Colleen S Young | Nurse Practitioner | 12401 Washington Blvd, Whittier, CA 90602-1006 | 2009-08-28 |
| 1346433372 | Colleen Kreidler Young | Dietitian, Registered | 114 Forrest Ave, Suite 104, Narberth, PA 19072-2218 | 2007-08-22 |
| Street Address |
1861 N ROCK RD SUITE 310 |
| City | WICHITA |
| State | KS |
| Zip Code | 67206-4200 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366416414 | Rebecca H Reddy | Pediatrics | 1861 N Rock Rd, Ste 105, Wichita, KS 67206-4200 | 2006-02-15 |
| 1235447780 | Trang Thien Do Brownlee | Physician Assistant | 1861 N Rock Rd, Ste 310, Wichita, KS 67206-4200 | 2010-09-17 |
| 1073723623 | Anita Louise Bradley Avers | Counselor | 1861 N Rock Rd, Suite 103, Wichita, KS 67206-4200 | 2007-05-23 |
| 1588704076 | Shanna D Suderman | Physician Assistant | 1861 N Rock Rd, Suite 310, Wichita, KS 67206-4200 | 2007-02-07 |
| 1770654063 | Baby Waves, Inc | Radiologic Technologist | 1861 N Rock Rd, Ste 200, Wichita, KS 67206-4200 | 2006-11-10 |
| 1770596512 | Steven M Passman | Dermatology | 1861 N Rock Rd, Suite 310, Wichita, KS 67206-4200 | 2006-08-14 |
| 1285685008 | Mid-kansas Dermatology Clinic, Pa | Dermatology | 1861 N Rock Rd, Suite 310, Wichita, KS 67206-4200 | 2006-05-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760020846 | Founders Surgery Center, LLC | Clinic/Center | 1961 N Founders Circle, Wichita, KS 67206 | 2019-12-19 |
| 1174006613 | Courtney Dawn Simon | Physical Therapist | 9360 E Central Ave Ste 100, Wichita, KS 67206 | 2018-09-11 |
| 1902308919 | Center At Waterfront LLC | Skilled Nursing Facility | 1541 North Lindberg Circle, Wichita, KS 67206 | 2018-03-06 |
| 1750804597 | Katelyn Aguiar | Psychologist | 250 N Rock Rd Ste 210, Wichita, KS 67206 | 2017-07-24 |
| 1457888778 | Mona Kay Cherryholmes | Social Worker | 1223 N. Rock Rd, Bldg A. Suite 100, Wichita, KS 67206 | 2017-05-17 |
| 1164899415 | Elizabeth Herl | Marriage & Family Therapist | 250 N Rock Rd Ste 150, Wichita, KS 67206 | 2015-08-21 |
| 1851715510 | Ndjj Corp | Custodial Care Facility | 6403 E Marjore, Wichita, KS 67206 | 2014-02-14 |
| 1801238217 | Courtney Ann Lang | Physical Therapist | 1603 North Chapel Hill Street, Suite 400, Wichita, KS 67206 | 2013-07-26 |
| 1194063032 | Peak Performance Health Pa | Chiropractor | 10111 E 21st St, #106, Wichita, KS 67206 | 2013-01-28 |
| 1750629002 | Rachel Marie Conrad | Speech-Language Pathologist | 1861 N. Rock Rd, Ste 101, Wichita, KS 67206 | 2013-01-22 |
| Find all providers in zip 67206 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891270674 | Kathryn Denise Boomer | Physician Assistant | 929 St. Francis N, Wichita, KS 67214 | 2018-09-27 |
| 1255888319 | Morgan J Martin | Physician Assistant | 2610 N Woodlawn, Wichita, KS 67220 | 2016-09-07 |
| 1437409901 | Crystal A Nelson | Physician Assistant | 9350 E 35th St N, Ste 101, Wichita, KS 67226 | 2012-09-12 |
| 1578847182 | Wellness Strategies LLC | Physician Assistant | 6224 East Shadybrook St., Wichita, KS 67208 | 2011-09-30 |
| 1346378460 | Gretchen H Waite | Physician Assistant | 1515 S Clifton Ave Ste 450, Wichita, KS 67218-2954 | 2007-03-01 |
| 1023153012 | James W Strickler | Physician Assistant | 2600 N. Woodlawn, Wichita, KS 67220-2729 | 2007-02-20 |
| 1730288861 | Kathryn S. Wolfe-wappelhorst | Physician Assistant | 2750 S Roosevelt St, Hunter Health Brookside Clinic, Wichita, KS 67210-1304 | 2006-09-22 |
| 1235242298 | Sarah Lindsey | Physician Assistant | 2716 W.central, Wichita, KS 67203-4904 | 2006-08-16 |
| 1013927342 | Paul Medina | Physician Assistant | 1911 W 21st St N, Wichita, KS 67203-2106 | 2006-08-09 |
| 1700809498 | Jennifer Smith | Physician Assistant | 8020 E Central Ave Ste 200, Wichita, KS 67206-2382 | 2006-07-25 |
| Find all providers in WICHITA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.