Individual provider Active NPI

Rachel Young, LAT, ATC

  • Athletic Trainer
  • Porter, TX
National Provider Identifier
1033683784
Registry record updated May 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
AT8239 Issued in TX
Practice address
4540 Woodridge Pkwy
Porter, TX 77365-7714
Phone
(281) 577-8880
NPI assigned
Jan 16, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 10, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X AT8239 TX Primary

Addresses

Primary practice location

4540 Woodridge Pkwy
Porter, TX 77365-7714

Mailing address

2611 Bens Branch Dr Apt 1913
Kingwood, TX 77339-4910
Phone (254) 592-5628

Other practice location 1

1333 W Washington St
Stephenville, TX 76401-4168
Phone (254) 592-5628

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

LicenseStateTypeSpecialty
AT8239TXMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1547596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652140800000",
    "number": "1033683784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2611 BENS BRANCH DR APT 1913",
            "city": "KINGWOOD",
            "state": "TX",
            "postal_code": "773394910",
            "telephone_number": "254-592-5628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4540 WOODRIDGE PKWY",
            "city": "PORTER",
            "state": "TX",
            "postal_code": "773657714",
            "telephone_number": "281-577-8880"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1333 W Washington St",
            "address_purpose": "LOCATION",
            "city": "Stephenville",
            "state": "TX",
            "postal_code": "764014168",
            "country_code": "US",
            "telephone_number": "254-592-5628",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "RACHEL",
        "credential": "LAT, ATC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-01-16",
        "last_updated": "2022-05-10",
        "certification_date": "2022-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "TX",
            "license": "AT8239",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Porter, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.