Individual provider Active NPI

Andrea Lavonne Youngblut

  • Nurse Practitioner
  • Waterloo, IA
National Provider Identifier
1427998608
Registry record updated Jun 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
A190436 Issued in IA
Practice address
2413 W Ridgeway Ave Ste 2
Waterloo, IA 50701-4310
Phone
(319) 236-1911
NPI assigned
Mar 30, 2026
Last updated
Jun 22, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2026

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 A190436 IA Primary

Addresses

Primary practice location

2413 W Ridgeway Ave Ste 2
Waterloo, IA 50701-4310

Mailing address

434 Hopkins St
Jesup, IA 50648-9739

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20260511000128 IA Practitioner - Nurse Practitioner 3274001029 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2026
Medicare assignment
May accept Medicare assignment
Group practices

Practice addresses (Care Compare)

1825 Logan Ave
Waterloo, IA 50703-1916
Phone (319) 235-3913

2413 W Ridgeway Ave
Uph Waterloo Neurosurgery
Waterloo, IA 50701-4306
Phone (319) 226-9888

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
A190436IAMDNurse Practitioner

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1774828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782086400000",
    "number": "1427998608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "434 HOPKINS ST",
            "city": "JESUP",
            "state": "IA",
            "postal_code": "506489739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2413 W RIDGEWAY AVE STE 2",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507014310",
            "telephone_number": "319-236-1911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNGBLUT",
        "first_name": "ANDREA",
        "middle_name": "LAVONNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-03-30",
        "last_updated": "2026-06-22",
        "certification_date": "2026-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IA",
            "license": "A190436",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterloo, IA

Sources for this page

Verify at the official NPI Registry.