Individual provider Active NPI

Amanda Young Roberts, M.D.

  • Family Medicine Physician
  • Akron, OH
National Provider Identifier
1073776274
Registry record updated Apr 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35.095233 Issued in OH
Practice address
525 N Cleveland Massillon Rd
Ste. 203
Akron, OH 44333-3360
Phone
(330) 666-9769
Fax
(330) 666-7530
NPI assigned
Jul 8, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 35.095233 OH Primary

Addresses

Primary practice location

525 N Cleveland Massillon Rd
Ste. 203
Akron, OH 44333-3360

Mailing address

525 N Cleveland Massillon Rd
Ste. 203
Akron, OH 44333-3360
Phone (330) 666-9769

Other names 1

  • Amanda I Young Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120613000114 OH Practitioner - Family Practice 0345404802 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35.095233OHMDFamily Medicine Physician

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1215475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334016000000",
    "number": "1073776274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 N CLEVELAND MASSILLON RD",
            "address_2": "STE. 203",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443333360",
            "telephone_number": "330-666-9769",
            "fax_number": "330-666-7530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 N CLEVELAND MASSILLON RD",
            "address_2": "STE. 203",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443333360",
            "telephone_number": "330-666-9769",
            "fax_number": "330-666-7530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "AMANDA",
        "middle_name": "YOUNG",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-08",
        "last_updated": "2012-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35.095233",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "YOUNG",
            "middle_name": "I",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Akron, OH

Sources for this page

Verify at the official NPI Registry.