Individual provider Active NPI

Marianne Elizabeth Youngblood, FNP-C

  • Family Nurse Practitioner
  • Beaumont, TX
National Provider Identifier
1033502745
Registry record updated Mar 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP127606 Issued in TX
Practice address
6510 Folsom Dr
Beaumont, TX 77706-7274
Phone
(409) 832-6545
Fax
(409) 832-7494
NPI assigned
Mar 5, 2015
Last updated
Mar 5, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP127606 TX Primary

Addresses

Primary practice location

6510 Folsom Dr
Beaumont, TX 77706-7274

Mailing address

6510 Folsom Dr
Beaumont, TX 77706-7274
Phone (409) 832-6545

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150318001067 TX Practitioner - Nurse Practitioner 9335466085 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Baptist Physician NetworkGroup PAC ID 0547333890, 121 clinicians

Practice addresses (Care Compare)

415 N Broadway St
China, TX 77613-2715
Phone (409) 752-2301

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP127606TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Physician Network CurrentSince Jul 15, 2022 Accepting new patients
Broussard Family Practice, PLLC Family Past Accepting new patients

Locations

3070 College St
Ste 120
Beaumont, TX 77701
Phone (409) 835-2300

3555 Stagg Dr
Beaumont, TX 77701
Phone (409) 212-5922

6450 Folsom Dr
Beaumont, TX 77706
Phone (409) 835-0524

810 Hospital Dr
Ste 100
Beaumont, TX 77701
Phone (409) 212-5933

Interoperability endpoints

  • Direct secure messaging: marianne.youngblood@bpn.eclinicaldirectplus.com

Organizations & group practices 2

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

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1425513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425513600000",
    "number": "1033502745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6510 FOLSOM DR",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777067274",
            "telephone_number": "409-832-6545",
            "fax_number": "409-832-7494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6510 FOLSOM DR",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777067274",
            "telephone_number": "409-832-6545",
            "fax_number": "409-832-7494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNGBLOOD",
        "first_name": "MARIANNE",
        "middle_name": "ELIZABETH",
        "name_prefix": "Ms.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-05",
        "last_updated": "2015-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP127606",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaumont, TX

Sources for this page

Verify at the official NPI Registry.