DR. ROSCOE C YOUNG JR. (NPI# 1265748073) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265748073 |
| Entity Type | Individual |
| Full Name | DR. ROSCOE C YOUNG JR. |
| Credential | MD |
| Practice Address |
505 Central Ave Nw Ste A Albuquerque NM 87102-3107 |
| Mailing Address |
7439 Via Serenita Sw Albuquerque NM 87121-1418 |
| Practice Telephone | 5052468020 |
| Practice Fax Number | 5052440081 |
| Mailing Telephone | 5052468020 |
| Mailing Fax Number | 5052440081 |
| Enumeration Date | 2010-08-31 |
| Last Update Date | 2010-08-31 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 171000000X | Military Health Care Provider | 2003-0464 | NM | Other Service Providers |
| Street Address |
505 CENTRAL AVE NW STE A |
| City | ALBUQUERQUE |
| State | NM |
| Zip Code | 87102-3107 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407454937 | Julie Wood | Acupuncturist | 1600 Luna Circle Nw, Albuquerque, NM 87102 | 2020-10-16 |
| 1770121410 | Emily Perez | Counselor | 218 Broadway Ne, Albuquerque, NM 87102 | 2019-12-12 |
| 1417503392 | Tess Holtry | Behavior Technician | 1424 Walter St Nw, Albuquerque, NM 87102 | 2019-08-15 |
| 1942867486 | Christy E Cheromiah | Behavioral Analyst | Open Skies Helathcare, 707 Broadway Blvd Ne, Albuquerque, NM 87102 | 2019-05-21 |
| 1730744103 | Faith Petra Maxwell | Behavior Technician | 900 Arno St, Albuquerque, NM 87102 | 2019-05-01 |
| 1568923761 | Storm Swinford | Behavioral Analyst | Open Skies Healthcare, 707 Broadway Blvd Ne, Albuquerque, NM 87102 | 2019-03-29 |
| 1093276651 | Tina Marie Trujillo | Behavioral Analyst | Open Skies Health Care, 707 Broadway Blvd Ne, Albuquerque, NM 87102 | 2019-03-27 |
| 1861950370 | Meghan Montoya | Student in an Organized Health Care Education/Training Program | 801 Camino De Salud, Albuquerque, NM 87102 | 2019-03-05 |
| 1174099329 | Dilshani N Tyson | Counselor | 600 1st Street Nw Ste 200, Albuquerque, NM 87102 | 2018-10-15 |
| 1962987925 | Tania L Goldfeder | Social Worker | New Mexico Solutions, 707 Broadway Ne Suite 500, Albuquerque, NM 87102 | 2018-09-26 |
| Find all providers in zip 87102 | ||||
| Taxonomy Code | 171000000X |
| Grouping | Other Service Providers |
| Classification | Military Health Care Provider |
| Active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes. |
| Notes: [7/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841803244 | Alyssa Marie Ortega | Military Health Care Provider | 4136 Rio Grande Blvd Nw, Albuquerque, NM 87107-3133 | 2020-08-25 |
| 1619430907 | Katelyn Jeanne Wilson | Military Health Care Provider | 1501 San Pedro Dr Se, Albuquerque, NM 87108-5153 | 2019-04-12 |
| 1518911254 | Richard Andrew Rock | Military Health Care Provider | 1501 San Pedro Dr Se, Albuquerque, NM 87108-5153 | 2006-05-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164581021 | Ann Marie Musto | Military Health Care Provider | 13 San Miguel Rd, Edgewood, NM 87015-7919 | 2006-12-07 |
| 1114526522 | Christopher Maestas | Military Health Care Provider | 2325 Cerrillos Rd, Santa Fe, NM 87505-3373 | 2020-10-19 |
| City | ALBUQUERQUE |
| Zip Code | 87102 |
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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.