Active NPI
Blaire Young
- Pharmacist
- Wimberley, TX
National Provider Identifier
1194447052
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 71202
- Practice address
- 65 Augusta Drive
Wimberley, TX 78676 - Phone
- (936) 465-0172
- NPI assigned
- Sep 16, 2022
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 71202 | TX | Primary |
Addresses
Primary practice location
65 Augusta Drive
Wimberley, TX 78676
Mailing address
PO Box 2497
Wimberley, TX 78676-7397
Phone (936) 465-0172
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | Walgreens | WALGREEN CO |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 71202 | TX | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1663286400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1663286400000",
"number": "1194447052",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2497",
"city": "WIMBERLEY",
"state": "TX",
"postal_code": "786767397",
"telephone_number": "936-465-0172"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "65 AUGUSTA DRIVE",
"city": "WIMBERLEY",
"state": "TX",
"postal_code": "78676",
"telephone_number": "936-465-0172"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YOUNG",
"first_name": "BLAIRE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-09-16",
"last_updated": "2022-09-16",
"certification_date": "2022-09-13",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TX",
"license": "71202",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "Walgreens",
"affiliation": "Y",
"affiliationName": "WALGREEN CO",
"address_1": "1700 Ranch Road 12",
"city": "San Marcos",
"state": "TX",
"country_code": "US",
"postal_code": "786662502",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Wimberley, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.