Individual provider Active NPI

Jamie Townsend Young, ATC

  • Sports Medicine (Physical Medicine & Rehabilitation) Physician
  • Kennesaw, GA
National Provider Identifier
1184113342
Registry record updated May 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081S0010X
License
AT001757 Issued in GA
Practice address
1275 Shiloh Rd NW Ste 2031
Kennesaw, GA 30144-7199
Phone
(678) 607-7325
NPI assigned
May 3, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Physical Medicine & Rehabilitation) Physician 2081S0010X AT001757 GA Primary

Addresses

Primary practice location

1275 Shiloh Rd NW Ste 2031
Kennesaw, GA 30144-7199

Mailing address

4841 Lake Park LN
Acworth, GA 30101-8800

Other practice location 1

4841 Lake Park Ln
Acworth, GA 30101-8800
Phone (706) 781-7500

Other names 1

  • Jamie Susanne Townsend Former name

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
AT001757GAMDSports Medicine (Physical Medicine & Rehabilitation) Physician

NPI Registry JSON

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

{
    "created_epoch": "1525305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525305600000",
    "number": "1184113342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4841 LAKE PARK LN",
            "city": "ACWORTH",
            "state": "GA",
            "postal_code": "301018800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1275 SHILOH RD NW STE 2031",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301447199",
            "telephone_number": "678-607-7325"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4841 Lake Park Ln",
            "address_purpose": "LOCATION",
            "city": "Acworth",
            "state": "GA",
            "postal_code": "301018800",
            "country_code": "US",
            "telephone_number": "706-781-7500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "JAMIE",
        "middle_name": "TOWNSEND",
        "name_prefix": "Mrs.",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-03",
        "last_updated": "2018-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "GA",
            "license": "AT001757",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JAMIE",
            "last_name": "TOWNSEND",
            "middle_name": "SUSANNE",
            "credential": "ATC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Kennesaw, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2018; 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.