NPIMap

Organization Active NPI

Bayside Therapy

  • Physical Rehabilitation Occupational Therapist
  • Melbourne, FL
National Provider Identifier
1922897479
Registry record updated May 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Rehabilitation Occupational TherapistTaxonomy code 225XP0019X
Legal business name
BAYSIDE THERAPY
Practice address
2075 Meadowlane Ave
Melbourne, FL 32904-4951
Phone
(321) 806-9395
NPI assigned
May 1, 2025
Last updated
May 5, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 5, 2025

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

Authorized official

Name
Crystal Young, COTA/LNPI 1609667005
Title
Ceo
Phone
(321) 806-9395

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 15

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Rehabilitation Medicine Physician 2081P0010X
Physical Therapist 225100000X
Cardiopulmonary Physical Therapist 2251C2600X
Ergonomics Physical Therapist 2251E1200X
Neurology Physical Therapist 2251N0400X
Pediatric Physical Therapist 2251P0200X
Neurorehabilitation Occupational Therapist 225XN1300X
Certified Respiratory Therapist 227800000X
Neonatal/Pediatric Certified Respiratory Therapist 2278P3900X
Speech-Language Assistant 2355S0801X
Speech-Language Pathologist 235Z00000X
Mental Health Occupational Therapist 225XM0800X
Physical Rehabilitation Occupational Therapist 225XP0019X Primary
Feeding, Eating & Swallowing Occupational Therapist 225XF0002X
Low Vision Occupational Therapist 225XL0004X

Addresses

Primary practice location

2075 Meadowlane Ave
Melbourne, FL 32904-4951

Mailing address

674 Old Country Rd SE
Palm Bay, FL 32909-6903
Phone (321) 806-9395

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1746057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1746403200000",
    "number": "1922897479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "674 OLD COUNTRY RD SE",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329096903",
            "telephone_number": "321-806-9395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2075 MEADOWLANE AVE",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329044951",
            "telephone_number": "321-806-9395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAYSIDE THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-05-01",
        "last_updated": "2025-05-05",
        "certification_date": "2025-05-05",
        "status": "A",
        "authorized_official_last_name": "YOUNG",
        "authorized_official_first_name": "CRYSTAL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "321-806-9395",
        "authorized_official_credential": "COTA/L"
    },
    "taxonomies": [
        {
            "code": "2081P0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pediatric Rehabilitation Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2251C2600X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Cardiopulmonary",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2251E1200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Ergonomics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2251N0400X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Neurology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225XN1300X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Neurorehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "227800000X",
            "taxonomy_group": "",
            "desc": "Respiratory Therapist, Certified",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2278P3900X",
            "taxonomy_group": "",
            "desc": "Respiratory Therapist, Certified, Neonatal/Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2355S0801X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225XM0800X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225XP0019X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Physical Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225XF0002X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Feeding, Eating & Swallowing",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225XL0004X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Low Vision",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2025; 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.