Active NPI
Andrea Leigh Young, COTA
- Occupational Therapy Assistant
- Greeneville, TN
National Provider Identifier
1164544870
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 096
- Practice address
- 1420 Tusculum Blvd
Greeneville, TN 37745-4279 - Phone
- (423) 787-5063
- NPI assigned
- Apr 4, 2007
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 096 | TN | Primary |
Addresses
Primary practice location
1420 Tusculum Blvd
Greeneville, TN 37745-4279
Mailing address
1616 Seminole Dr
Apt. 211
Johnson City, TN 37604-7052
Phone (423) 677-7024
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 |
|---|---|---|---|
| 096 | TN | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175644800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1164544870",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1616 SEMINOLE DR",
"address_2": "APT. 211",
"city": "JOHNSON CITY",
"state": "TN",
"postal_code": "376047052",
"telephone_number": "423-677-7024"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1420 TUSCULUM BLVD",
"city": "GREENEVILLE",
"state": "TN",
"postal_code": "377454279",
"telephone_number": "423-787-5063"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YOUNG",
"first_name": "ANDREA",
"middle_name": "LEIGH",
"credential": "COTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-04",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "TN",
"license": "096",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Greeneville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.