Michael Brandon Young, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5536 Issued in MS

Practice address

17550 E Main St
Louisville, MS 39339-2772

Phone

(662) 773-6211

NPI assigned

Oct 19, 2018

Last updated

Oct 19, 2018By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Michael Brandon Young Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1539907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539907200000",
    "number": "1326514092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "517 MOORES CREEK RD",
            "city": "MABEN",
            "state": "MS",
            "postal_code": "397505537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17550 E MAIN ST",
            "city": "LOUISVILLE",
            "state": "MS",
            "postal_code": "393392772",
            "telephone_number": "662-773-6211"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "409 Tyler Holmes Dr",
            "address_purpose": "LOCATION",
            "city": "Winona",
            "state": "MS",
            "postal_code": "389671521",
            "country_code": "US",
            "telephone_number": "662-283-4114",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "MICHAEL",
        "middle_name": "BRANDON",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-10-19",
        "last_updated": "2018-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MS",
            "license": "5536",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHAEL",
            "last_name": "YOUNG",
            "middle_name": "BRANDON",
            "credential": "PT, DPT",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Physical Therapist in Louisville, MS
• Providers in Louisville, MS by specialty
• Physical Therapist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 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.