Active NPI
David Allen Young
- Prosthetic/Orthotic Supplier
- Wayzata, MN
National Provider Identifier
1932758067
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthetic/Orthotic Supplier
- Practice address
- 1163 Wayzata Blvd E
Wayzata, MN 55391-1935 - Phone
- (952) 473-8248
- NPI assigned
- Sep 11, 2019
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Prosthetic/Orthotic Supplier | 335E00000X | Primary |
Addresses
Primary practice location
1163 Wayzata Blvd E
Wayzata, MN 55391-1935
Mailing address
1163 Wayzata Blvd E
Wayzata, MN 55391-1935
Phone (952) 473-8248
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1568160000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1568160000000",
"number": "1932758067",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1163 WAYZATA BLVD E",
"city": "WAYZATA",
"state": "MN",
"postal_code": "553911935",
"telephone_number": "952-473-8248"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1163 WAYZATA BLVD E",
"city": "WAYZATA",
"state": "MN",
"postal_code": "553911935",
"telephone_number": "952-473-8248"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YOUNG",
"first_name": "DAVID",
"middle_name": "ALLEN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-09-11",
"last_updated": "2019-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "335E00000X",
"taxonomy_group": "",
"desc": "Prosthetic/Orthotic Supplier",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Wayzata, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 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.