Active NPI
Amy Lauren Young, DPT
- Physical Therapist
- Kailua Kona, HI
National Provider Identifier
1376311688
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 5832
- Practice address
- 75-5699 Kopiko St Ste a
Kailua Kona, HI 96740-3651 - Phone
- (808) 329-7744
- NPI assigned
- Dec 15, 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 | 5832 | HI | Primary |
Addresses
Primary practice location
75-5699 Kopiko St Ste a
Kailua Kona, HI 96740-3651
Mailing address
75-5699 Kopiko St
Kailua Kona, HI 96740-3651
Phone (808) 329-7744
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in HI
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5832 | HI | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Club Rehab, Inc. | Physical Therapist | Current | Accepting new patients |
Locations
75-5699 Kopiko St
Kailua Kona, HI 96740
Phone (808) 329-7744
75-5699 Kopiko St
Ste A
Kailua Kona, HI 96740
Phone (808) 329-7744
73-5590 Kauhola St
Ste A
Kailua Kona, HI 96740
Phone (808) 329-7744
73-5590 Kauhola St
Ste A
Kailua Kona, HI 96740
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1702598400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1702598400000",
"number": "1376311688",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "75-5699 KOPIKO ST",
"city": "KAILUA KONA",
"state": "HI",
"postal_code": "967403651",
"telephone_number": "808-329-7744"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "75-5699 KOPIKO ST STE A",
"city": "KAILUA KONA",
"state": "HI",
"postal_code": "967403651",
"telephone_number": "808-329-7744"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YOUNG",
"first_name": "AMY",
"middle_name": "LAUREN",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-12-15",
"last_updated": "2023-12-15",
"certification_date": "2023-12-15",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "HI",
"license": "5832",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Kailua Kona, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.