John Patrick Young, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

2009011517 Issued in MO

Practice address

1010 Liggett Ave
Building # 690
Tacoma, WA 98433

Phone

(227) 325-3982

NPI assigned

Apr 23, 2012

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Sports Medicine and Training Center

  • Physical Therapy Clinic/Center
  • Saint Louis, MO
  • NPI 1790873883
  NPD (past)

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

{
    "created_epoch": "1335139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660521600000",
    "number": "1356608897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11418 105TH AVE SW APT H6",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984986856",
            "telephone_number": "314-224-9810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 LIGGETT AVE",
            "address_2": "BUILDING # 690",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "98433",
            "telephone_number": "227-325-3982"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8235 Clayton Rd",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631171107",
            "country_code": "US",
            "telephone_number": "314-961-3787",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "JOHN",
        "middle_name": "PATRICK",
        "name_prefix": "Mr.",
        "credential": "ATC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-04-23",
        "last_updated": "2022-08-15",
        "certification_date": "2022-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MO",
            "license": "2009011517",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anne Young, MSW
• Carolyn Sanae Young, RN
• Colleen Young, PEER COUNSELOR
• Colleen Anne Young, MA
• Deozana E Young
• Justin Noah Young
• Kara Young, DNP
• Kaylie Young, MD
• Lynette Marie Elena Young, MSW
• Mara Young, ARNP

• Athletic Trainer in Tacoma, WA
• Providers in Tacoma, WA by specialty
• Athletic Trainer in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 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.