Active NPI
Kimberly Youngs Grand
- Physical Therapist
- Terrytown, LA
National Provider Identifier
1245912195
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Practice address
- 1610 Belle Chasse Hwy
Terrytown, LA 70056-7056 - Phone
- (504) 362-1000
- Fax
- (504) 584-7747
- NPI assigned
- Aug 1, 2023
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | Primary |
Addresses
Primary practice location
1610 Belle Chasse Hwy
Terrytown, LA 70056-7056
Mailing address
1610 Belle Chasse Hwy
Terrytown, LA 70056-7056
Phone (504) 362-1000
Other practice location 1
102 Woodland Hwy
Belle Chasse, LA 70037-1674
Phone (504) 392-7000
Other practice location 2
27136 Highway 23
Port Sulphur, LA 70083-2602
Phone (504) 582-0775
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11388R | LA | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1690848000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1690848000000",
"number": "1245912195",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1610 BELLE CHASSE HWY",
"city": "TERRYTOWN",
"state": "LA",
"postal_code": "700567056",
"telephone_number": "504-362-1000",
"fax_number": "504-584-7747"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1610 BELLE CHASSE HWY",
"city": "TERRYTOWN",
"state": "LA",
"postal_code": "700567056",
"telephone_number": "504-362-1000",
"fax_number": "504-584-7747"
}
],
"practiceLocations": [
{
"address_1": "102 Woodland Hwy",
"address_purpose": "LOCATION",
"city": "Belle Chasse",
"state": "LA",
"postal_code": "700371674",
"country_code": "US",
"telephone_number": "504-392-7000",
"fax_number": "504-584-7747",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "27136 Highway 23",
"address_purpose": "LOCATION",
"city": "Port Sulphur",
"state": "LA",
"postal_code": "700832602",
"country_code": "US",
"telephone_number": "504-582-0775",
"fax_number": "504-584-7747",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "YOUNGS GRAND",
"first_name": "KIMBERLY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-08-01",
"last_updated": "2023-08-01",
"certification_date": "2023-08-01",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Terrytown, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.