Active NPI
Scott Bradley Youngblood
- Behavior Technician
- Boise, ID
National Provider Identifier
1063221216
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 1087 E Park Blvd
Suite 100
Boise, ID 83712 - Phone
- (208) 584-6130
- NPI assigned
- Jan 2, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | Primary |
Addresses
Primary practice location
1087 E Park Blvd
Suite 100
Boise, ID 83712
Mailing address
2733 S Law Ave
Boise, ID 83706-6338
Phone (208) 863-6515
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1735776000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1735776000000",
"number": "1063221216",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2733 S LAW AVE",
"city": "BOISE",
"state": "ID",
"postal_code": "837066338",
"telephone_number": "208-863-6515"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1087 E PARK BLVD",
"address_2": "SUITE 100",
"city": "BOISE",
"state": "ID",
"postal_code": "83712",
"telephone_number": "208-584-6130"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YOUNGBLOOD",
"first_name": "SCOTT",
"middle_name": "BRADLEY",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2025-01-02",
"last_updated": "2025-01-02",
"certification_date": "2024-12-28",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boise, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.