Individual provider Active NPI

Allison Youngberg, COTA/L

  • Occupational Therapy Assistant
  • Winter Haven, FL
National Provider Identifier
1316685423
Registry record updated May 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
18946 Issued in FL
Practice address
101 Overlook Dr.
Suite 100
Winter Haven, FL 33884
Phone
(863) 268-2608
NPI assigned
May 27, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 18946 FL Primary

Addresses

Primary practice location

101 Overlook Dr.
Suite 100
Winter Haven, FL 33884

Mailing address

2832 Skyview Dr
Lakeland, FL 33801-7068
Phone (941) 585-8481

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

NPI Registry JSON

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

{
    "created_epoch": "1653609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653609600000",
    "number": "1316685423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2832 SKYVIEW DR",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338017068",
            "telephone_number": "941-585-8481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 OVERLOOK DR.",
            "address_2": "SUITE 100",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "33884",
            "telephone_number": "863-268-2608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNGBERG",
        "first_name": "ALLISON",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-27",
        "last_updated": "2022-05-27",
        "certification_date": "2022-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "FL",
            "license": "18946",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Haven, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2022; 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.