Individual provider Active NPI

Corey Young, MPT

  • Physical Therapist
  • Wheeling, WV
National Provider Identifier
1255796603
Registry record updated Dec 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT 002507 Issued in WV
Practice address
21 Washington Ave
Wheeling, WV 26003-6261
Phone
(304) 242-5233
Fax
(304) 230-1132
NPI assigned
Dec 29, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT 002507 WV Primary
Physical Therapist 225100000X PT012739 OH

Addresses

Primary practice location

21 Washington Ave
Wheeling, WV 26003-6261

Mailing address

510 W Main St
Ste B
Canfield, OH 44406-1454
Phone (330) 702-0110

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

LicenseStateTypeSpecialty
PT012739OHMDPhysical Therapist
PT 002507WVMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1451347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1451347200000",
    "number": "1255796603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 W MAIN ST",
            "address_2": "STE B",
            "city": "CANFIELD",
            "state": "OH",
            "postal_code": "444061454",
            "telephone_number": "330-702-0110",
            "fax_number": "330-702-0510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 WASHINGTON AVE",
            "city": "WHEELING",
            "state": "WV",
            "postal_code": "260036261",
            "telephone_number": "304-242-5233",
            "fax_number": "304-230-1132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "COREY",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-12-29",
        "last_updated": "2015-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WV",
            "license": "PT 002507",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "PT012739",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wheeling, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2015; 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.