Individual provider Active NPI

Sarah Youngblood, FNP

  • Nurse Practitioner
  • Beaumont, TX
National Provider Identifier
1306479605
Registry record updated Apr 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP144741 Issued in TX
Practice address
3080 College St
Beaumont, TX 77701-4606
Phone
(409) 212-5115
NPI assigned
Feb 15, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 6, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AP144741 TX Primary

Addresses

Primary practice location

3080 College St
Beaumont, TX 77701-4606

Mailing address

3080 College St
Beaumont, TX 77701-4606
Phone (409) 212-5115

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200428001898 TX Practitioner - Nurse Practitioner 8426488768 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP144741TXMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Physician Network CurrentSince Apr 1, 2020 Accepting new patients

Locations

3555 Stagg Dr
Beaumont, TX 77701
Phone (409) 212-5922

3070 College St
Ste 100B
Beaumont, TX 77701
Phone (409) 212-7110

3080 College St
Beaumont, TX 77701
Phone (409) 212-5000

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.

NPI Registry JSON

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

{
    "created_epoch": "1581724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617667200000",
    "number": "1306479605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3080 COLLEGE ST",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777014606",
            "telephone_number": "409-212-5115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3080 COLLEGE ST",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777014606",
            "telephone_number": "409-212-5115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNGBLOOD",
        "first_name": "SARAH",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-02-15",
        "last_updated": "2021-04-06",
        "certification_date": "2021-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "AP144741",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaumont, TX

Sources for this page

Verify at the official NPI Registry.