Individual provider Active NPI

Stephen Moss Young, MPT OCS

  • Physical Therapist
  • Summersville, WV
National Provider Identifier
1942280979
Registry record updated May 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2052 Issued in WV
Practice address
207 Merchants Walk
Summersville, WV 26651
Phone
(304) 872-7498
Fax
(304) 872-8144
NPI assigned
Jan 17, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2052 WV Primary

Addresses

Primary practice location

207 Merchants Walk
Summersville, WV 26651

Mailing address

P.O. Box 69
Summersville, WV 26651
Phone (304) 872-7498

Other identifiers 1

IdentifierTypeStateIssuer
7305025001MedicaidWV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041104000128 WV Practitioner - Physical Therapist in Private Practice 9931161627 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mountaineer Physical Therapy and Sports MedicineGroup PAC ID 1153383849, 3 clinicians

Practice addresses (Care Compare)

207 Merchants Walk
Summersville, WV 26651-1901
Phone (304) 872-7498

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2052WVMDFamily Medicine Physician
002052WVMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mountaineer Physical Therapy & Sports Medicine Physical Therapist CurrentSince Jun 18, 2001 Accepting new patients

Locations

223 Maple Ave
Oak Hill, WV 25901
Phone (304) 465-6416

207 Merchants Walk
Summersville, WV 26651
Phone (304) 872-7498

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1137456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747267200000",
    "number": "1942280979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 69",
            "city": "SUMMERSVILLE",
            "state": "WV",
            "postal_code": "26651",
            "telephone_number": "304-872-7498",
            "fax_number": "304-872-8144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 MERCHANTS WALK",
            "city": "SUMMERSVILLE",
            "state": "WV",
            "postal_code": "26651",
            "telephone_number": "304-872-7498",
            "fax_number": "304-872-8144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "STEPHEN",
        "middle_name": "MOSS",
        "name_prefix": "Mr.",
        "credential": "MPT OCS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-17",
        "last_updated": "2025-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WV",
            "license": "2052",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7305025001",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Summersville, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.