Active NPI
Taylor Young, ATC
- Athletic Trainer
- Greenwood, MS
National Provider Identifier
1407212160
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- AT0775
- Practice address
- 415 Cherokee Rd
Greenwood, MS 38930-2912 - Phone
- (662) 897-9794
- NPI assigned
- Jan 12, 2016
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | AT0775 | MS | Primary |
Addresses
Primary practice location
415 Cherokee Rd
Greenwood, MS 38930-2912
Mailing address
415 Cherokee Rd
Greenwood, MS 38930-2912
Phone (662) 897-9794
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AT0775 | MS | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1452556800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1452556800000",
"number": "1407212160",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "415 CHEROKEE RD",
"city": "GREENWOOD",
"state": "MS",
"postal_code": "389302912",
"telephone_number": "662-897-9794"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "415 CHEROKEE RD",
"city": "GREENWOOD",
"state": "MS",
"postal_code": "389302912",
"telephone_number": "662-897-9794"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YOUNG",
"first_name": "TAYLOR",
"credential": "ATC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-01-12",
"last_updated": "2016-01-12",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "MS",
"license": "AT0775",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Greenwood, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.