Active NPI
Clinton E. Youngberg, D.C.
- Chiropractor
- Pocatello, ID
National Provider Identifier
1356480131
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- CHIA-1232
- Practice address
- 1598 Delphic Way
Suite a-2
Pocatello, ID 83201-2285 - Phone
- (208) 232-0220
- Fax
- (208) 237-9569
- NPI assigned
- Feb 6, 2007
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Chiropractor | 111N00000X | CHIA-1232 | ID | Primary |
Addresses
Primary practice location
1598 Delphic Way
Suite a-2
Pocatello, ID 83201-2285
Mailing address
1598 Delphic Way
Suite a-2
Pocatello, ID 83201-2285
Phone (208) 232-0220
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CHIA-1232 | ID | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170720000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1356480131",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1598 DELPHIC WAY",
"address_2": "SUITE A-2",
"city": "POCATELLO",
"state": "ID",
"postal_code": "832012285",
"telephone_number": "208-232-0220"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1598 DELPHIC WAY",
"address_2": "SUITE A-2",
"city": "POCATELLO",
"state": "ID",
"postal_code": "832012285",
"telephone_number": "208-232-0220",
"fax_number": "208-237-9569"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YOUNGBERG",
"first_name": "CLINTON",
"middle_name": "E.",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-06",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "ID",
"license": "CHIA-1232",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pocatello, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.