Active NPI
Kneel and Youngblood, MD
- Emergency Medicine Physician
- Dallas, TX
National Provider Identifier
1235543430
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- G3929
- Practice address
- 300 Crescent CT
#1380
Dallas, TX 75201-1876 - Phone
- (214) 855-0194
- Fax
- (214) 855-1230
- NPI assigned
- Jun 16, 2014
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | G3929 | TX | Primary |
Addresses
Primary practice location
300 Crescent CT
#1380
Dallas, TX 75201-1876
Mailing address
300 Crescent CT
#1380
Dallas, TX 75201-1876
Phone (214) 855-0194
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G3929 | TX | MD | Emergency Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1402876800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1402876800000",
"number": "1235543430",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 CRESCENT CT",
"address_2": "#1380",
"city": "DALLAS",
"state": "TX",
"postal_code": "752011876",
"telephone_number": "214-855-0194",
"fax_number": "214-855-1230"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 CRESCENT CT",
"address_2": "#1380",
"city": "DALLAS",
"state": "TX",
"postal_code": "752011876",
"telephone_number": "214-855-0194",
"fax_number": "214-855-1230"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YOUNGBLOOD",
"first_name": "KNEEL AND",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-06-16",
"last_updated": "2014-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "TX",
"license": "G3929",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.