Individual provider Active NPI

Montana Young, OT

  • Occupational Therapist
  • Gainesville, GA
National Provider Identifier
1750191532
Registry record updated Jan 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT009414 Issued in GA
Practice address
3640 Mundy Mill Rd Ste 102B
Gainesville, GA 30504-8226
Phone
(770) 287-8821
NPI assigned
Jan 13, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT009414 GA Primary

Addresses

Primary practice location

3640 Mundy Mill Rd Ste 102B
Gainesville, GA 30504-8226

Mailing address

1200 Corporate Dr Ste 400
Hoover, AL 35242-5424
Phone (423) 497-0005

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250225000161 GA Practitioner - Occupational Therapist in Private Practice 7113447939 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Independent Physical Therapy of Georgia, LLCGroup PAC ID 2961312244, 526 clinicians

Practice addresses (Care Compare)

3640 Mundy Mill Rd
Suite 102B
Gainesville, GA 30504-8226
Phone (770) 287-8821

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OT009414GAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Agilitas USA Inc Occupational Therapist CurrentSince Jan 13, 2025 Accepting new patients
Drayer Physical Therapy Georgia LLC Occupational Therapist CurrentSince Jan 13, 2025 Accepting new patients
Benchmark Physical Therapy Inc Occupational Therapist CurrentSince Jan 13, 2025 Accepting new patients
Independent Physical Therapy of Georgia, LLC Occupational Therapist CurrentSince Jan 13, 2025 Accepting new patients
Independent Physical Therapy of Georgia, LLC Occupational Therapist CurrentSince Jan 13, 2025 Accepting new patients
Benchmark Physical Therapy, Inc CurrentSince Jan 13, 2025 Accepting new patients
Agilitas USA, Inc Occupational Therapist CurrentSince Jan 13, 2025 Accepting new patients

Locations

1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568

1025 E West Connector
Ste 406
Austell, GA 30106
Phone (770) 384-1001

3640 Mundy Mill Rd
Ste 102B
Gainesville, GA 30504
Phone (770) 287-8821

7130 Mount Zion Blvd
Ste 9
Jonesboro, GA 30236
Phone (770) 603-5660

3455 Highway 81
Loganville, GA 30052
Phone (678) 635-8280

11490 Alpharetta Hwy
Ste 200
Roswell, GA 30076
Phone (770) 740-8592

6397 Lee Hwy
Ste 300
Chattanooga, TN 37421
Phone (423) 238-8923

Organizations & group practices 7

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": "1736726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736726400000",
    "number": "1750191532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 CORPORATE DR STE 400",
            "city": "HOOVER",
            "state": "AL",
            "postal_code": "352425424",
            "telephone_number": "423-497-0005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3640 MUNDY MILL RD STE 102B",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305048226",
            "telephone_number": "770-287-8821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "MONTANA",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-01-13",
        "last_updated": "2025-01-13",
        "certification_date": "2025-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "GA",
            "license": "OT009414",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.