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Sally Ann Young , ATC-L

Contractor β€’ Fort Wayne, IN

Active NPI 1053386474 Individual Practitioner Female Practitioner
Practice location in NPPES

3946 Ice Way
Fort Wayne, IN 468051018

Call 2602664007 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

3946 Ice Way

Fort Wayne, IN 468051018

Telephone 2602664007

NPI first issued

2006

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Compared with the same specialty in Fort Wayne and Indiana

8 active clinicians are listed under Contractor with a practice address in Fort Wayne, IN (332 in Indiana).

Addresses are self-reported to NPPES and may be out of date.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2026-07-21
Contractor Primary Specialty

NUCC Taxonomy Code: 171W00000X

License # reported to NPPES IN 36000029A

A person who contracts to supply certain materials or do certain work for a stipulated sum; esp., one whose business is contracting work in any of the building trades. For purposes of the taxonomy, a person who contracts to complete home repairs or modifications to accommodate a health condition (e.g. wheelchair ramp, kitchen counter lowering).

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Indiana Professional Licensing Agency.
Look Up on State Board Site

Clinicians Sharing This Practice Address or Phone

Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.

5 listed
Jodi Chambers , PA

Physician Assistant

NPI 1487646469

Physician Assistant

NPI 1578791398

Doctor of Osteopathic Medicine (D.O.)

NPI 1811444763

Physician Assistant (Certified), Licensed Athletic Trainer, Certified Athletic Trainer

Anne Fisher , PA-C

Physician Assistant

NPI 1346421864

Physician Assistant (Certified)

Benjamin Steele , PA-C

Physician Assistant

NPI 1710395736

Physician Assistant (Certified)

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

8 Historical Events
πŸ“
Updated Practice Location July 21, 2026

Registered at 3946 ICE WAY, FORT WAYNE, IN 468051018 (Tel: 2602664007)

πŸ“
Updated Business Mailing Address July 21, 2026

Registered at 3946 ICE WAY, FORT WAYNE, IN 468051018 (Tel: 2602664007)

βœ…
NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) July 08, 2007

Registered at 6422 E STATE ROAD 218, WALTON, IN 469949303 (Tel: 5746262511)

πŸ“
Business Mailing Address (Initial Record) July 08, 2007

Registered at 314 W JACKSON ST, GALVESTON, IN 469328791 (Tel: 5746996449)

πŸ‘€
Provider Name / Credentials (Initial Record) July 08, 2007

Recorded as SALLY YOUNG, A.T.C.-L

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Contractor (license number reported to NPPES: IN 36000029A)

🟒
Initial NPI Registration & Enumeration February 20, 2006

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1053386474
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: February 20, 2006
Last Update: July 21, 2026
Sole Proprietor: No

Mailing Address

3946 Ice Way

Fort Wayne, IN 468051018

Phone: 2602664007

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.