Mary Nell Young, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

02193 Issued in TN

Practice address

3960 New Covington Pike
Memphis, TN 38128-2504

Phone

(901) 516-5320

Fax

(901) 516-5099

NPI assigned

Apr 11, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Miss Mary Nell Denomie Former name

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.

• Unique Potential Network, Inc.

  • Physical Therapist
  • Cordova, TN
  • NPI 1881826352
  NPD (past)

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

{
    "created_epoch": "1554940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588204800000",
    "number": "1730642174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10778 E RIDGE DR",
            "city": "OLIVE BRANCH",
            "state": "MS",
            "postal_code": "386544359",
            "telephone_number": "901-491-4934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3960 NEW COVINGTON PIKE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381282504",
            "telephone_number": "901-516-5320",
            "fax_number": "901-516-5099"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2075 N Germantown Pkwy Ste 108",
            "address_purpose": "LOCATION",
            "city": "Cordova",
            "state": "TN",
            "postal_code": "380161730",
            "country_code": "US",
            "telephone_number": "901-336-4902",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "MARY",
        "middle_name": "NELL",
        "name_prefix": "Mrs.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-11",
        "last_updated": "2020-04-30",
        "certification_date": "2020-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "TN",
            "license": "02193",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "DENOMIE",
            "middle_name": "NELL",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• James Young, DNP
• Joyceann Lynom Young, PH.D
• Kailah Young
• Larry Young, DPH
• Lucy Caroline Young, MD
• Matthew Young
• Morgan Ruth Young, DO
• Rashedah Darmika Young, DNP NURSE ANESTHESIA
• Robbie Young
• Roger Charles Young, MD

• Physical Therapy Assistant in Memphis, TN
• Providers in Memphis, TN by specialty
• Physical Therapy Assistant in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2020; 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.