Kimberly Youngberg

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

008528 Issued in NY

Practice address

75 Jones and Gifford Ave
Jamestown, NY 14701-2828

Phone

(716) 661-1408

Fax

(716) 661-1074

NPI assigned

Oct 30, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1414627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414627200000",
    "number": "1932504123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 PARKVIEW AVE",
            "city": "JAMESTOWN",
            "state": "NY",
            "postal_code": "147018333",
            "telephone_number": "716-969-9968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 JONES AND GIFFORD AVE",
            "city": "JAMESTOWN",
            "state": "NY",
            "postal_code": "147012828",
            "telephone_number": "716-661-1408",
            "fax_number": "716-661-1074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNGBERG",
        "first_name": "KIMBERLY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-10-30",
        "last_updated": "2014-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "NY",
            "license": "008528",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Disa Xayavongsone, NP
• Yan Liu, M.D., PLLC
• Joseph P Yanulevich, CRNA
• Jennifer Yerico
• Melinda Young
• Ashley Diana Zaffino, PTA
• Brittany Zamborik
• Karen Zickgraf, COTA
• Sarah Ann Zinni
• Paulette C Ziomek, PA

• Occupational Therapy Assistant in Jamestown, NY
• Providers in Jamestown, NY by specialty
• Occupational Therapy Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2014; 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.