NPIMap

Organization Active NPI

Gwendolyn V Youngblood, MD, PC

  • Pediatrics Physician
  • Greenbelt, MD
National Provider Identifier
1578035135
Registry record updated Dec 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
GWENDOLYN V YOUNGBLOOD, MD, PC
Practice address
7525 Greenway Center Dr Ste 311
Greenbelt, MD 20770-3525
Phone
(301) 441-4555
Fax
(301) 441-3420
NPI assigned
Dec 20, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2018

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

Authorized official

Name
Gwendolyn Virginia Youngblood, MDNPI 1235224452
Title
Owner
Phone
(301) 441-4555

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

7525 Greenway Center Dr Ste 311
Greenbelt, MD 20770-3525

Mailing address

7525 Greenway Center Dr Ste 311
Greenbelt, MD 20770-3525
Phone (301) 441-4555

Other practice location 1

7525 Greenway Center Dr Ste 311
Greenbelt, MD 20770-3525
Phone (301) 441-4555

Other identifiers 1

IdentifierTypeStateIssuer
195661201MedicaidMD

National Provider Directory

National Provider Directory

Locations

7525 Greenway Center Dr
Ste 311
Greenbelt, MD 20770
Phone (301) 441-4555

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/15431/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1545264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1545264000000",
    "number": "1578035135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7525 GREENWAY CENTER DR STE 311",
            "city": "GREENBELT",
            "state": "MD",
            "postal_code": "207703525",
            "telephone_number": "301-441-4555",
            "fax_number": "301-441-3420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7525 GREENWAY CENTER DR STE 311",
            "city": "GREENBELT",
            "state": "MD",
            "postal_code": "207703525",
            "telephone_number": "301-441-4555",
            "fax_number": "301-441-3420"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7525 Greenway Center Dr Ste 311",
            "address_purpose": "LOCATION",
            "city": "Greenbelt",
            "state": "MD",
            "postal_code": "207703525",
            "country_code": "US",
            "telephone_number": "301-441-4555",
            "fax_number": "301-441-3420",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "GWENDOLYN V YOUNGBLOOD, MD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-20",
        "last_updated": "2018-12-20",
        "status": "A",
        "authorized_official_last_name": "YOUNGBLOOD",
        "authorized_official_first_name": "GWENDOLYN",
        "authorized_official_middle_name": "VIRGINIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "301-441-4555",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "195661201",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenbelt, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.