Individual provider Active NPI

Ann Marie Young, OT

  • Occupational Therapist
  • Benbrook, TX
National Provider Identifier
1053127837
Registry record updated Dec 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
125121 Issued in TX
Practice address
6407 Southwest Blvd
Benbrook, TX 76132-2777
Phone
(817) 423-5611
NPI assigned
Dec 6, 2024
Last updated
Dec 6, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 125121 TX Primary

Addresses

Primary practice location

6407 Southwest Blvd
Benbrook, TX 76132-2777

Mailing address

PO Box 932184
Atlanta, GA 31193-2184

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241211004834 TX Practitioner - Occupational Therapist in Private Practice 7315473444 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Endeavor Rehab Center IncGroup PAC ID 6800989369, 123 clinicians

Practice addresses (Care Compare)

5632 Edwards Ranch Rd
Suite 110 Fort Worth Physical Therapy
Ft Worth, TX 76109-4102
Phone (817) 259-0600

6407 Southwest Blvd
Benbrook, TX 76132-2777
Phone (817) 423-5611

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
125121TXMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Endeavor Rehab Center Inc CurrentSince Dec 2, 2024 Accepting new patients
Endeavor Rehab Center Inc Occupational Therapist CurrentSince Dec 2, 2024 Accepting new patients

Locations

6911 Ranch Road 620 N
Austin, TX 78732
Phone (512) 219-8533

6407 Southwest Blvd
Benbrook, TX 76132
Phone (817) 423-5611

5632 Edwards Ranch Rd
Ft Worth, TX 76109
Phone (817) 259-0600

896 Summit St
Round Rock, TX 78664
Phone (512) 599-4262

110 Mary Lou Dr
Ste 100
Willow Park, TX 76087
Phone (817) 423-5611

Interoperability endpoints

  • Direct secure messaging: ann.young.p1@direct.thc.nextgenshare.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1733443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733443200000",
    "number": "1053127837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 932184",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "311932184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6407 SOUTHWEST BLVD",
            "city": "BENBROOK",
            "state": "TX",
            "postal_code": "761322777",
            "telephone_number": "817-423-5611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "ANN",
        "middle_name": "MARIE",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-12-06",
        "last_updated": "2024-12-06",
        "certification_date": "2024-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TX",
            "license": "125121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Benbrook, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.