Individual provider Active NPI

Clifton G Youngblood, MD

  • Obstetrics & Gynecology Physician
  • Demorest, GA
National Provider Identifier
1275617078
Registry record updated Apr 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
036050 Issued in GA
Practice address
541 Historic Highway 441 North
Demorest, GA 30535
Phone
(706) 839-4000
NPI assigned
Oct 25, 2006
Last updated
Apr 8, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 036050 GA Primary

Addresses

Primary practice location

541 Historic Highway 441 North
Demorest, GA 30535

Mailing address

PO Box 742616
Atlanta, GA 30374-2616
Phone (770) 219-8420

Other practice location 1

81 Upper Riverdale Rd
Suite 210
Riverdale, GA 30274-2627
Phone (770) 996-1200

Other identifiers 1

IdentifierTypeStateIssuer
00509781DMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101220000943 GA Practitioner - Obstetrics/Gynecology 0840209185 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Alabama School of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Piedmont Providers LLCGroup PAC ID 9830082825, 526 clinicians
My OBGYN PCGroup PAC ID 9335120997, 2 clinicians

Practice addresses (Care Compare)

1133 Eagles Landing Pkwy
Stockbridge, GA 30281-5085
Phone (678) 604-1000

81 Upper Riverdale Rd SW
Riverdale, GA 30274-2627
Phone (770) 996-1200

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036050GAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Southeast Permanente Medical Group Obstetrics & Gynecology CurrentSince Jun 1, 2025 Accepting new patients
Piedmont Providers LLC CurrentSince Jan 7, 2026 Accepting new patients
My OBGYN PC CurrentSince Apr 1, 2000 Accepting new patients
Northeast Georgia Physicians Group Inc CurrentSince Apr 1, 2025 Accepting new patients
Piedmont Henry Hospital, Inc. Past Accepting new patients

Locations

1984 Peachtree Rd NW
Ste 300
Atlanta, GA 30309
Phone (404) 367-3210

3495 Piedmont Rd NE
Bldg 9
Atlanta, GA 30305
Phone (404) 364-7000

541 441 Historic Hwy N
Demorest, GA 30535
Phone (706) 839-4000

597 S Enota Dr NE
Gainesville, GA 30501
Phone (770) 219-8275

335 Upper Riverdale Rd
Ste C13
Jonesboro, GA 30236
Phone (770) 996-1200

81 Upper Riverdale Rd SW
Ste 210
Riverdale, GA 30274
Phone (770) 996-1200

1133 Eagles Landing Pkwy
Stockbridge, GA 30281
Phone (678) 604-1000

Interoperability endpoints

  • Direct secure messaging: clifton.youngblood.1@27053.direct.athenahealth.com

Organizations & group practices 5

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 2

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": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744070400000",
    "number": "1275617078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 742616",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303742616",
            "telephone_number": "770-219-8420",
            "fax_number": "770-907-7492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "541 HISTORIC HIGHWAY 441 NORTH",
            "city": "DEMOREST",
            "state": "GA",
            "postal_code": "30535",
            "telephone_number": "706-839-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "81 Upper Riverdale Rd",
            "address_2": "Suite 210",
            "address_purpose": "LOCATION",
            "city": "Riverdale",
            "state": "GA",
            "postal_code": "302742627",
            "country_code": "US",
            "telephone_number": "770-996-1200",
            "fax_number": "770-907-7492",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YOUNGBLOOD",
        "first_name": "CLIFTON",
        "middle_name": "G",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-25",
        "last_updated": "2025-04-08",
        "certification_date": "2025-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "GA",
            "license": "036050",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00509781D",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Demorest, GA

Sources for this page

Verify at the official NPI Registry.