Individual provider Active NPI

Mary Youmans, PTA

  • Physical Therapy Assistant
  • Gifford, IL
National Provider Identifier
1982011433
Registry record updated Jul 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
160.005594 Issued in IL
Practice address
2304 County Road 3000 N
Gifford, IL 61847-9756
Phone
(217) 568-7362
Fax
(217) 568-7314
NPI assigned
Jul 16, 2014
Last updated
Jul 16, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 160.005594 IL Primary

Addresses

Primary practice location

2304 County Road 3000 N
Gifford, IL 61847-9756

Mailing address

550 W Frontage Rd
Suite 2415
Northfield, IL 60093-1202
Phone (877) 787-2422

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

State licenses

LicenseStateTypeSpecialty
160.005594ILMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1405468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405468800000",
    "number": "1982011433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 W FRONTAGE RD",
            "address_2": "SUITE 2415",
            "city": "NORTHFIELD",
            "state": "IL",
            "postal_code": "600931202",
            "telephone_number": "877-787-2422",
            "fax_number": "618-398-8304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2304 COUNTY ROAD 3000 N",
            "city": "GIFFORD",
            "state": "IL",
            "postal_code": "618479756",
            "telephone_number": "217-568-7362",
            "fax_number": "217-568-7314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUMANS",
        "first_name": "MARY",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-16",
        "last_updated": "2014-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IL",
            "license": "160.005594",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gifford, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 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.