Active NPI
Kari Marie Youngblood, DPT
- Physical Therapist
- Forty Fort, PA
National Provider Identifier
1104868066
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT016432
- Practice address
- 190 Welles St
Suite 166
Forty Fort, PA 18704-4968 - Phone
- (570) 714-4177
- Fax
- (570) 714-4188
- NPI assigned
- Jun 12, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT016432 | PA | Primary |
Addresses
Primary practice location
190 Welles St
Suite 166
Forty Fort, PA 18704-4968
Mailing address
190 Welles St
Suite 166
Forty Fort, PA 18704-4968
Phone (570) 714-4177
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT016432 | PA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Intermountain Medical Group, Inc | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Clinical Medical Laboratory
- Kingston, PA
- NPI 1932271624
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150070400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1104868066",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "190 WELLES ST",
"address_2": "SUITE 166",
"city": "FORTY FORT",
"state": "PA",
"postal_code": "187044968",
"telephone_number": "570-714-4177",
"fax_number": "570-714-4188"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "190 WELLES ST",
"address_2": "SUITE 166",
"city": "FORTY FORT",
"state": "PA",
"postal_code": "187044968",
"telephone_number": "570-714-4177",
"fax_number": "570-714-4188"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YOUNGBLOOD",
"first_name": "KARI",
"middle_name": "MARIE",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-12",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "PA",
"license": "PT016432",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Forty Fort, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.