NPIMap

Individual provider Active NPI

Jess H Youngblood, M.D.

  • General Practice Physician
  • Guntersville, AL
National Provider Identifier
1467676676
Registry record updated Jan 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
27882 Issued in AL
Practice address
2017 Obrig Ave
Guntersville, AL 35976-2156
Phone
(256) 582-2324
Fax
(256) 582-2321
NPI assigned
Apr 12, 2007
Last updated
Jan 10, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 10, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 27882 AL Primary

Addresses

Primary practice location

2017 Obrig Ave
Guntersville, AL 35976-2156

Mailing address

2017 Obrig Ave
Guntersville, AL 35976-2156
Phone (256) 582-2324

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070906000796 AL Practitioner - Family PracticePractitioner - General PracticePractitioner - Emergency Medicine 4688767650 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: General Practice
Education
University of Mississippi School of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Premier Family Care, LLCGroup PAC ID 5597959767, 3 clinicians
Premier Family Care Arab LLCGroup PAC ID 1658671839, 7 clinicians

Practice addresses (Care Compare)

1407 Blount Ave
Guntersville, AL 35976-1888
Phone (256) 582-2324

20 S Main St
Arab, AL 35016-1394
Phone (833) 586-2324

68278 Main St
Blountsville, AL 35031-3370
Phone (225) 644-3940

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
27882ALMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Family Care Blountsville, LLC CurrentSince Nov 1, 2020 Accepting new patients
Premier Family Care Arab LLC CurrentSince May 28, 2015 Accepting new patients
Premier Family Care, LLC CurrentSince Jan 3, 2011 Accepting new patients
Premier Family Care Blountsville, LLC CurrentSince Nov 1, 2020 Accepting new patients
Premier Family Care, LLC Past Accepting new patients
Premier Family Care Arab LLC Past Accepting new patients

Locations

20 S Main St
Arab, AL 35016
Phone (256) 586-2324

68278 Main St
Blountsville, AL 35031
Phone (205) 429-4151

1407 Blount Ave
Guntersville, AL 35976
Phone (256) 582-2324

2017 Obrig Ave
Guntersville, AL 35976
Phone (256) 582-2324

Interoperability endpoints

  • Direct secure messaging: jess.youngblood.premierfamilycarearab@pfca.direct.systemedx.com
  • Direct secure messaging: jess.youngblood@pfc.direct.systemedx.com

Ownership & related parties

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Premier Family Care, LLCGuntersville, AL, CCN 013957 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
W-2 Managing Employee (100%)		 Nov 1, 2010
Nov 1, 2010
Premier Family Care Arab LLCArab, AL, CCN 018921 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Corporate Officer
Corporate Director		 Nov 2, 2015
Nov 2, 2015
Nov 2, 2015
Premier Family CareBlountsville, AL, CCN 018949 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
W-2 Managing Employee		 Nov 16, 2020
Nov 16, 2020

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 6

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 7

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": "1176336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294617600000",
    "number": "1467676676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2017 OBRIG AVE",
            "city": "GUNTERSVILLE",
            "state": "AL",
            "postal_code": "359762156",
            "telephone_number": "256-582-2324",
            "fax_number": "256-582-2321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2017 OBRIG AVE",
            "city": "GUNTERSVILLE",
            "state": "AL",
            "postal_code": "359762156",
            "telephone_number": "256-582-2324",
            "fax_number": "256-582-2321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNGBLOOD",
        "first_name": "JESS",
        "middle_name": "H",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-12",
        "last_updated": "2011-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "AL",
            "license": "27882",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Guntersville, AL

Sources for this page

Verify at the official NPI Registry.