Individual provider Active NPI

Amy Lauren Young, DPT

  • Physical Therapist
  • Kailua Kona, HI
National Provider Identifier
1376311688
Registry record updated Dec 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5832 Issued in HI
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

Updated by the provider on Dec 15, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

Enrollment IDStateProvider typePAC IDDetails
I20250711000726 HI Practitioner - Physical Therapist in Private Practice 5597270447 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5832HIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Club Rehab, Inc. Physical Therapist CurrentSince Apr 3, 2025 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.

Verify at the official NPI Registry.