Mary Kistler Crouch Young, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

11-06245 Issued in KS

Practice address

3599 Rainbow Blvd
Kansas City, KS 66103-2078

Phone

(913) 588-1203

NPI assigned

Oct 2, 2019

Last updated

Oct 2, 2019By the provider in NPPES

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1569974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569974400000",
    "number": "1760023550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6434 ACUFF ST",
            "city": "SHAWNEE",
            "state": "KS",
            "postal_code": "662162167",
            "telephone_number": "909-200-8209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3599 RAINBOW BLVD",
            "city": "KANSAS CITY",
            "state": "KS",
            "postal_code": "661032078",
            "telephone_number": "913-588-1203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROUCH YOUNG",
        "first_name": "MARY",
        "middle_name": "KISTLER",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-02",
        "last_updated": "2019-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KS",
            "license": "11-06245",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "m619c741@kumc.edu",
            "affiliation": "N",
            "endpointDescription": "Work email",
            "address_1": "3599 Rainbow Blvd",
            "city": "Kansas City",
            "state": "KS",
            "country_code": "US",
            "postal_code": "661032078",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Physical Therapist in Kansas City, KS
• Providers in Kansas City, KS by specialty
• Physical Therapist in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2019; 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.