Samantha Jane Young

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

License

6062 Issued in MN

Practice address

15590 90TH St NE
Otsego, MN 55330-9452

Phone

(763) 755-4275

Fax

(763) 755-4261

NPI assigned

Jan 2, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Family Speech & Therapy Services, LLC

  • Speech-Language Pathologist
  • Andover, MN
  • NPI 1235285966
  Medicare reassignment NPD

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

{
    "created_epoch": "1704153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704153600000",
    "number": "1013787001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1723 N 66TH ST",
            "city": "SUPERIOR",
            "state": "WI",
            "postal_code": "548806043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15590 90TH ST NE",
            "city": "OTSEGO",
            "state": "MN",
            "postal_code": "553309452",
            "telephone_number": "763-755-4275",
            "fax_number": "763-755-4261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "SAMANTHA",
        "middle_name": "JANE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-02",
        "last_updated": "2024-01-02",
        "certification_date": "2024-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "MN",
            "license": "6062",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole Elisabeth West, MASSAGE THERAPIST
• David Alan Wheelhouse, LADC, CPP
• Mary Wieczorek, R.N
• Sophie Grace Williams
• Nicollet Sue Young, OTD
• Yufanyi Holding Group LLC Paramount Care
• John Ctsiambu Yufanyi
• Louis Kory Zam, D.C.
• Michelle M Zirngible

• Pediatric Occupational Therapist in Otsego, MN
• Providers in Otsego, MN by specialty
• Pediatric Occupational Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.