Jennifer Lynn Youngblood, COTA/L

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

2303 Issued in NM

Practice address

507 S Lea Ave Apt a
Roswell, NM 88203-4565

Phone

(505) 637-9942

NPI assigned

Jul 31, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1185840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1185840000000",
    "number": "1023208477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "507 S LEA AVE APT A",
            "city": "ROSWELL",
            "state": "NM",
            "postal_code": "882034565",
            "telephone_number": "505-637-9942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "507 S LEA AVE APT A",
            "city": "ROSWELL",
            "state": "NM",
            "postal_code": "882034565",
            "telephone_number": "505-637-9942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNGBLOOD",
        "first_name": "JENNIFER",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "COTA/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-31",
        "last_updated": "2007-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "NM",
            "license": "2303",
            "primary": true
        },
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "TX",
            "license": "209781",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas W Wulf, M.D.
• Chandra Sekhar Yangalasetty, MD
• Hany Nagy Yassa, MD
• Richard W. Yeager, R.PH.
• Jennifer Youngblood
• Yumi Wellness Support
• Frances Zaragoza
• Evelyn Zavala
• Jose Cruz Zavala, MSW
• Joanna Zuczkiewicz

• Occupational Therapy Assistant in Roswell, NM
• Providers in Roswell, NM by specialty
• Occupational Therapy Assistant in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2007; 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.