KELLY LEE YOUNG (NPI# 1053924423) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053924423 |
| Entity Type | Individual |
| Full Name | KELLY LEE YOUNG |
| Practice Address |
87 Swierkos Dr Moundsville WV 26041-4209 |
| Mailing Address |
413 Clinton Ave Moundsville WV 26041-2002 |
| Practice Telephone | 3048430910 |
| Enumeration Date | 2020-08-26 |
| Last Update Date | 2020-08-26 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3747P1801X |
Technician Specialization: Personal Care Attendant |
WV | Nursing Service Related Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WV | 12555234 | 05 | |
| WV | 1821206228 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063058600 | Kelly Young | Registered Nurse | 501 Howard Ave Ste D, Altoona, PA 16601-4810 | 2019-11-19 |
| 1861842700 | Kelly Michelle Young | Physician Assistant | 2424 Erwin Rd Ste 201, Durham, NC 27705-3825 | 2016-06-21 |
| 1508216631 | Kelly Young | Marriage & Family Therapist | 7350 Heritage Village Plz Unit 102, Gainesville, VA 20155-3085 | 2016-06-20 |
| 1013394865 | Kelly Ann Young | Dietitian, Registered | 1380 El Cajon Blvd, El Cajon, CA 92020-5703 | 2015-04-30 |
| 1306144167 | Kelly Marie Young | Counselor | 201 Houston St Ste 104, Batavia, IL 60510-1960 | 2011-03-03 |
| 1164736641 | Kelly Young | Physical Therapy Assistant | 396 Lake Nepessing Rd., Lapeer, MI 48446-2910 | 2010-07-27 |
| 1922246099 | Kelly Young | Social Worker | 3140 Tarrant Ln, Plano, TX 75025-5291 | 2009-01-28 |
| 1265682801 | Kelly Shannon Young | Physical Therapist | 1151 Robeson Street, Fall River, MA 02720-5566 | 2008-09-19 |
| 1851598833 | Kelly Elizabeth Young | Dentist | 2005 Saint Charles St Ste 5, Jasper, IN 47546-9146 | 2007-07-02 |
| 1598381121 | Kelly Young | Behavior Technician | 5175 Old Clemmons School Road, Winston Salem, NC 27102 | 2020-06-19 |
| Street Address |
87 SWIERKOS DR |
| City | MOUNDSVILLE |
| State | WV |
| Zip Code | 26041-4209 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417575846 | Billie Jo Oconnell | Case Manager/Care Coordinator | 87 Swierkos Dr, Moundsville, WV 26041-4209 | 2020-07-13 |
| 1255932158 | Ronald Joseph Riser Jr. | Technician | 87 Swierkos Dr, Moundsville, WV 26041-4209 | 2020-11-06 |
| 1356942270 | India Rose Blackburn | Technician | 87 Swierkos Dr, Moundsville, WV 26041-4209 | 2020-11-06 |
| 1992306971 | Mary Regina Bassett | Technician | 87 Swierkos Dr, Moundsville, WV 26041-4209 | 2020-11-05 |
| 1851991822 | Eva Anna Anthony | Technician | 87 Swierkos Dr, Moundsville, WV 26041-4209 | 2020-10-29 |
| 1689274995 | Tara Renee Matts | Technician | 87 Swierkos Dr, Moundsville, WV 26041-4209 | 2020-10-27 |
| 1467052837 | Kelly Newbrough | Technician | 87 Swierkos Dr, Moundsville, WV 26041-4209 | 2020-10-27 |
| 1043819766 | Jennifer Lynn Perry | Technician | 87 Swierkos Dr, Moundsville, WV 26041-4209 | 2020-10-23 |
| 1316546039 | Matthew Abshire | Technician | 87 Swierkos Dr, Moundsville, WV 26041-4209 | 2020-10-23 |
| 1396344024 | Jessica Ernest | Technician | 87 Swierkos Dr, Moundsville, WV 26041-4209 | 2020-10-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093272577 | Tonya Sue Roush | Technician | 2056 Center Street, Moundsville, WV 26041 | 2019-02-21 |
| 1720568264 | Christina Robinson | Registered Nurse | Washington Lands Elementary, 116 School Rd., Moundsville, WV 26041 | 2018-08-15 |
| 1962935296 | Tracy A. Zang | Dentist | 112 Correctional Dr., Northern Regional Correctional Facility, Moundsville, WV 26041 | 2017-04-04 |
| 1154861052 | Andrea Garrison | Specialist/Technologist | 633 Blairs Ridge Rd, Moundsville, WV 26041 | 2017-02-27 |
| 1932643418 | First Settlement Physical Therapy | Physical Therapist | 1216 Lafayette Ave, Moundsville, WV 26041 | 2016-12-19 |
| 1245772177 | The Village Network | Community/Behavioral Health | 52 Fourteenth Street, Wheeling, WV 26041 | 2016-11-09 |
| 1144516683 | Sarah D Dean | Counselor | 324 7th and Lafayette Street, Moundsville, WV 26041 | 2011-06-23 |
| 1114101540 | Becky Poling | Speech-Language Pathologist | 2700 Eastern Fourth Street, Moundsville, WV 26041 | 2007-12-20 |
| 1871775213 | Cathy Jones | Registered Nurse | 2700 Fourth Street, Marshall County Board of Education, Moundsville, WV 26041 | 2007-11-28 |
| 1326262536 | Marshall County Health Department | Public Health or Welfare | 6th Street & Court Avenue, Moundsville, WV 26041 | 2007-04-12 |
| Find all providers in zip 26041 | ||||
| Taxonomy Code | 3747P1801X |
| Grouping | Nursing Service Related Providers |
| Classification | Technician |
| Specialization | Personal Care Attendant |
| An individual who provides assistance with eating, bathing, dressing, personal hygiene, activities of daily living as specified in the plan of care. Services which are incidental to the care furnished, or essential to the health and welfare of the individual may also be provided. Personal care providers must meet state defined training and certification standards |
| Notes: [7/1/2003: definition added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598365199 | Sharon Lynn Herchuck | Technician | 1507 4th St, Moundsville, WV 26041-1732 | 2020-11-01 |
| 1710586557 | Donna Ann Mullins | Technician | 28 Tracey Ln, Moundsville, WV 26041-4174 | 2020-10-22 |
| 1609475508 | Rebekah Dawn Furbee | Technician | 1284 Toms Run Ln, Moundsville, WV 26041-2714 | 2020-10-21 |
| 1992303176 | Timmy Lee Stout | Technician | 21 1/2 Walnut Ave, Moundsville, WV 26041-1139 | 2020-10-11 |
| 1306456603 | Brenda Posey | Technician | 201 Candle Wick Ave Unit 2, Moundsville, WV 26041-1100 | 2020-08-03 |
| 1093272577 | Tonya Sue Roush | Technician | 2056 Center Street, Moundsville, WV 26041 | 2019-02-21 |
| 1265946966 | Kimberly J Woods | Technician | 2499 Fork Ridge Rd, Moundsville, WV 26041-3189 | 2017-11-17 |
| 1255932158 | Ronald Joseph Riser Jr. | Technician | 87 Swierkos Dr, Moundsville, WV 26041-4209 | 2020-11-06 |
| 1356942270 | India Rose Blackburn | Technician | 87 Swierkos Dr, Moundsville, WV 26041-4209 | 2020-11-06 |
| 1992306971 | Mary Regina Bassett | Technician | 87 Swierkos Dr, Moundsville, WV 26041-4209 | 2020-11-05 |
| Find all providers in MOUNDSVILLE | ||||
| City | MOUNDSVILLE |
| Zip Code | 26041 |
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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.