Kristin Young

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PTA4952 Issued in MS

Practice address

12261 US 49 #14
Gulfport, MS 39503

Phone

(228) 539-3636

NPI assigned

May 17, 2022

Last updated

May 17, 2022By the provider in NPPES

Sex

Female

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

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

{
    "created_epoch": "1652745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652745600000",
    "number": "1649917089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "614 SARAZEN DR",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395072225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12261 US 49 #14",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "39503",
            "telephone_number": "228-539-3636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "KRISTIN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-05-17",
        "last_updated": "2022-05-17",
        "certification_date": "2022-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MS",
            "license": "PTA4952",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Xquisite Haar Loss Restoration Center LLC
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• Tong Yang, DMD
• Vyomahardath Yarlagadda, MD
• Saeeda Yasmin, MD
• Gaela Youngblood, PSY.D.
• Tyler Shea Youngblood, RBT
• Sadaf Zahra, M.D
• Kubra Zainab, M.D
• Lauren Suzanne Zakaras, LCSW, DBH

• Physical Therapy Assistant in Gulfport, MS
• Providers in Gulfport, MS by specialty
• Physical Therapy Assistant in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 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.