Larry David Youngblood III, PT, DPT, ATC, LAT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT016469 Issued in GA

Practice address

3708 Northside Dr
Macon, GA 31210-2404

Phone

(478) 750-2801

Fax

(478) 832-6506

NPI assigned

Sep 15, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Evans Rehabilitation Services, LLCGroup PAC ID 2769467034, 20 clinicians

Macon Orthopaedic and Hand Center, PAGroup PAC ID 7911994835, shared by 7 NPIs, 87 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Evans Rehabilitation Services, LLC

  • Physical Therapist
  • Evans, GA
  • NPI 1093715773
  Medicare reassignment Care Compare group NPD
• Houston Orthopedic Surgery & Sports Medicine, P.C.

  • Orthopaedic Surgery Physician
  • Warner Robins, GA
  • NPI 1205866605
  Medicare reassignment NPD
• Houston Orthopedic Surgery & Sports Medicine, P.C.

  • Durable Medical Equipment & Medical Supplies
  • Perry, GA
  • NPI 1134563042
  NPD
• Gcsu Athletic Training

  • Athletic Trainer
  • Milledgeville, GA
  • NPI 1033111638
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1505433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783296000000",
    "number": "1306365895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3708 NORTHSIDE DR",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312102404",
            "telephone_number": "478-745-4206",
            "fax_number": "478-832-6506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3708 NORTHSIDE DR",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312102404",
            "telephone_number": "478-750-2801",
            "fax_number": "478-832-6506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNGBLOOD",
        "first_name": "LARRY",
        "middle_name": "DAVID",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "PT, DPT, ATC, LAT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-09-15",
        "last_updated": "2026-07-06",
        "certification_date": "2026-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT016469",
            "primary": true
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "GA",
            "license": "AT003284",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jaquetta Young
• Joshua Shane Young, N.P.
• Nelliena Simone Young, MD
• Amber N Youngblood
• John Owen Youngblood III, MS, LAT, ATC
• Rachel Hinson Youngblood, PA-C
• Mallory Lynn Youngstrom, M.D.
• Abdelmoneim Ibrahim Younis, DVM, PHD
• Albarra Younis
• Your Corner Drug Store LLC

• Physical Therapist in Macon, GA
• Providers in Macon, GA by specialty
• Physical Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.