Active NPI
Andrea Young, L.M.T.
- Massage Therapist
- Columbia, MO
National Provider Identifier
1033439401
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 2010010227
- Practice address
- 19 E Walnut St
C
Columbia, MO 65203-4505 - Phone
- (573) 355-6636
- NPI assigned
- Jun 8, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 2010010227 | MO | Primary |
Addresses
Primary practice location
19 E Walnut St
C
Columbia, MO 65203-4505
Mailing address
19 E Walnut St
C
Columbia, MO 65203-4505
Phone (573) 355-6636
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2010010227 | MO | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1275955200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1293494400000",
"number": "1033439401",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19 E WALNUT ST",
"address_2": "C",
"city": "COLUMBIA",
"state": "MO",
"postal_code": "652034505",
"telephone_number": "573-355-6636"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19 E WALNUT ST",
"address_2": "C",
"city": "COLUMBIA",
"state": "MO",
"postal_code": "652034505",
"telephone_number": "573-355-6636"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YOUNG",
"first_name": "ANDREA",
"credential": "L.M.T.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-06-08",
"last_updated": "2010-12-28",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "MO",
"license": "2010010227",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Columbia, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.