MRS. SHANNON JOHNSON YOUNGER PA-C NPI 1164961629

NPI Information

NPI: 1164961629
Provider Name: MRS. SHANNON JOHNSON YOUNGER, PA-C
Classification: Physician Assistant - 363AM0700X
Entity Type: Individual

Specialization: Medical

PECOS Registration: Yes

Address:
724 LEIGH DR
COLUMBUS, MS
ZIP 39705
Phone: (662) 328-3375
Get Directions

MRS. Shannon Johnson Younger, PA-C is a medical physician assistant in Columbus, MS. MRS. Shannon Johnson Younger, PA-C NPI is 1164961629. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

724 LEIGH DR
COLUMBUS, MS
ZIP 39705-098
Phone: (662) 328-3375
Fax: (662) 328-3395

The NPI 1164961629 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 2/16/2017 and was last updated on 4/24/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363AM0700X	Physician Assistant	Medical	PA9110198	FLORIDA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	PA00395	OTHER	MISSISSIPPI	MISSISSIPPI PA CERTIFICATE
2	PA9110198	OTHER	FLORIDA	59-2455010

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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