Amy E Young, SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

S3340 Issued in MS

Practice address

471 Hwy 590
Ellisville, MS 39437

Phone

(601) 319-4046

NPI assigned

May 26, 2009

Last updated

Sep 10, 2012By 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

Other identifiers 1

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Breaking Boundaries, LLC

  • Speech-Language Pathologist
  • Ellisville, MS
  • NPI 1528609278
  NPD (past) Authorized official

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

{
    "created_epoch": "1243296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347235200000",
    "number": "1891920518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "471 HWY 590",
            "city": "ELLISVILLE",
            "state": "MS",
            "postal_code": "391575120",
            "telephone_number": "601-319-4056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "471 HWY 590",
            "city": "ELLISVILLE",
            "state": "MS",
            "postal_code": "39437",
            "telephone_number": "601-319-4046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "AMY",
        "middle_name": "E",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-26",
        "last_updated": "2012-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MS",
            "license": "S3340",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MS LICENSE",
            "identifier": "S3340",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jessie Watson, CPNP
• Benjamin Michael Weber, M.D.
• Roxie West, IDD WAIVER SERVICES
• Ranesha Williams, IDD WAIVER SERVICES
• Augustus Joseph Woestman, PT, DPT

• Speech-Language Pathologist in Ellisville, MS
• Providers in Ellisville, MS by specialty
• Speech-Language Pathologist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2012; 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.