NPIMap

Individual provider Active NPI

Mary Katherine Youngblood, M.D.

  • Rheumatology Physician
  • Lexington, KY
National Provider Identifier
1376734731
Registry record updated Aug 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
TP312 Issued in KY
Practice address
740 S Limestone
Lexington, KY 40536-3120
Phone
(859) 323-6700
Fax
(859) 257-1331
NPI assigned
Aug 9, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology Physician 207RR0500X ME63721 FL
Rheumatology Physician 207RR0500X 66432 WI
Rheumatology Physician 207RR0500X TP312 KY Primary

Addresses

Primary practice location

740 S Limestone
Lexington, KY 40536-3120

Mailing address

1301 2ND Ave SW
Largo, FL 33770-3120
Phone (727) 584-7706

Other practice location 1

1301 2nd Ave SW
Largo, FL 33770-3120
Phone (727) 584-7706

Other practice location 2

3111 Gundersen Dr
Onalaska, WI 54650-8447
Phone (608) 782-7300

Other identifiers 4

IdentifierTypeStateIssuer
1000649OtherFLCAREPLUS
4355089OtherFLAETNA
373864700MedicaidFL
23324OtherFLBCBS

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address myoungblood304021@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/
Direct Messaging Address him@marshfieldclinichealthsystem.cernerdirect.com Other

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, KY, MN3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20161103001154 WI Practitioner - Rheumatology 5193718773 Reassigns benefits to 3 organizations
I20230201001337 KY Practitioner - Rheumatology 5193718773 Reassigns benefits to 1 organization
I20250730001854 MN Practitioner - Rheumatology 5193718773

Care Compare profile

Medicare Care Compare
Specialty
Rheumatology
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1702 University Dr S
Fargo, ND 58103-4940

Hospital & facility affiliations

  • Essentia Health St Joseph'S Medical Center Hospital, Brainerd, MN, CCN 240075

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
TP312KYMDCardiovascular Disease Physician
66432WIMDRheumatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Marshfield Clinic Inc CurrentSince Oct 31, 2016 Accepting new patients
Gundersen Lutheran Medical Center Inc CurrentSince Aug 5, 2024 Accepting new patients
Gundersen Lutheran Medical Center Inc Current Accepting new patients
University of Kentucky CurrentSince Jan 19, 2023 Accepting new patients
MCHS Hospitals Inc CurrentSince Mar 1, 2018 Accepting new patients
Gundersen Lutheran Medical Center, Inc CurrentSince Aug 5, 2024 Accepting new patients
MCHS Hospitals Inc CurrentSince Mar 1, 2018 Accepting new patients

Locations

800 Rose St
Lexington, KY 40536
Phone (859) 257-8562

3501 Golf Rd
Eau Claire, WI 54701
Phone (715) 858-4200

1000 Starr Ave
Eau Claire, WI 54703
Phone (715) 858-4850

1910 South Ave
La Crosse, WI 54601
Phone (608) 775-2287

1000 N Oak Ave
Marshfield, WI 54449
Phone (715) 387-5111

3111 Gundersen Dr
Onalaska, WI 54650
Phone (608) 775-8100

2727 Plaza Dr
Wausau, WI 54401
Phone (715) 847-3000

Interoperability endpoints

  • Direct secure messaging: myoungblood889900@direct.gundersenhealth.org
  • Direct secure messaging: him@marshfieldclinichealthsystem.cernerdirect.com
  • Direct secure messaging: myoungblood304021@direct.myadvocateaurora.org

Organizations & group practices 7

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.

Hospital & facility affiliations 10

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": "1186617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722816000000",
    "number": "1376734731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 2ND AVE SW",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337703120",
            "telephone_number": "727-584-7706",
            "fax_number": "727-582-9323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "740 S LIMESTONE",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405363120",
            "telephone_number": "859-323-6700",
            "fax_number": "859-257-1331"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1301 2nd Ave SW",
            "address_purpose": "LOCATION",
            "city": "Largo",
            "state": "FL",
            "postal_code": "337703120",
            "country_code": "US",
            "telephone_number": "727-584-7706",
            "fax_number": "727-582-9323",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3111 Gundersen Dr",
            "address_purpose": "LOCATION",
            "city": "Onalaska",
            "state": "WI",
            "postal_code": "546508447",
            "country_code": "US",
            "telephone_number": "608-782-7300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YOUNGBLOOD",
        "first_name": "MARY",
        "middle_name": "KATHERINE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-09",
        "last_updated": "2024-08-05",
        "certification_date": "2024-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "FL",
            "license": "ME63721",
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "WI",
            "license": "66432",
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "KY",
            "license": "TP312",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREPLUS",
            "identifier": "1000649",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4355089",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "373864700",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "23324",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "myoungblood304021@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1301 2nd Ave SW",
            "city": "Largo",
            "state": "FL",
            "country_code": "US",
            "postal_code": "337703120",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "1301 2nd Ave SW",
            "city": "Largo",
            "state": "FL",
            "country_code": "US",
            "postal_code": "337703120",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "him@marshfieldclinichealthsystem.cernerdirect.com",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "Other",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Other",
            "address_1": "1000 N Oak Ave",
            "city": "Marshfield",
            "state": "WI",
            "country_code": "US",
            "postal_code": "544495703",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.