Stefan B Young, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

002219 Issued in WV

Practice address

4825 Maccorkle Ave SW Suite F, South Charleston WV 2530
South Charleston, WV 25309

Phone

(304) 346-9667

NPI assigned

Jun 26, 2023

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1687737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687737600000",
    "number": "1043996002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4825 MACCORKLE AVE SW SUITE F, SOUTH CHARLESTON WV 2530",
            "city": "SOUTH CHARLESTON",
            "state": "WV",
            "postal_code": "25309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4825 MACCORKLE AVE SW SUITE F, SOUTH CHARLESTON WV 2530",
            "city": "SOUTH CHARLESTON",
            "state": "WV",
            "postal_code": "25309",
            "telephone_number": "304-346-9667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "STEFAN",
        "middle_name": "B",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-06-26",
        "last_updated": "2023-06-26",
        "certification_date": "2023-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WV",
            "license": "002219",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Natasha Yates
• Kaylan Ynacay
• Laura Yoey
• Erica Nicole Young
• Nevaeh Young
• Mohammad Babar Yousaf, M.D.
• Amanda Marie Zaha
• Joshua Zegeer, MD
• Chad Michael Zemanski
• Ziad Kahwash

• Physical Therapy Assistant in South Charleston, WV
• Providers in South Charleston, WV by specialty
• Physical Therapy Assistant in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2023; 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.