Active NPI
Katherine Young
- Occupational Therapist
- Fsihersville, VA
National Provider Identifier
1215237912
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 0119005200
- Practice address
- 243 Woodrow Wilson Lane
Fsihersville, VA 22939 - Phone
- (540) 332-7087
- Fax
- (540) 332-7006
- NPI assigned
- Oct 27, 2010
- Last updated
- Oct 27, 2010
- 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 Therapist | 225X00000X | 0119005200 | VA | Primary |
Addresses
Primary practice location
243 Woodrow Wilson Lane
Fsihersville, VA 22939
Mailing address
PO Box 1500
Fishersville, VA 22939-1500
Phone (540) 332-7087
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629049143 | Medicaid | VA | |
| 1457458804 | Other | VA | ANTHEM |
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 |
|---|---|---|---|
| 0119005200 | VA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1288137600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1288137600000",
"number": "1215237912",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1500",
"city": "FISHERSVILLE",
"state": "VA",
"postal_code": "229391500",
"telephone_number": "540-332-7087",
"fax_number": "540-332-7006"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "243 WOODROW WILSON LANE",
"city": "FSIHERSVILLE",
"state": "VA",
"postal_code": "22939",
"telephone_number": "540-332-7087",
"fax_number": "540-332-7006"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YOUNG",
"first_name": "KATHERINE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-10-27",
"last_updated": "2010-10-27",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "VA",
"license": "0119005200",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1629049143",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "1457458804",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.