Individual provider Active NPI

Xoa T Youngblood, PHARM. D.

  • Pharmacist
  • Aurora, CO
National Provider Identifier
1831426634
Registry record updated Mar 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
18109 Issued in CO
Practice address
16601 E Centretech Pkwy
Aurora, CO 80011-9045
Phone
(303) 739-4936
Fax
(303) 739-4936
NPI assigned
Nov 16, 2009
Last updated
Mar 30, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 18109 CO Primary

Addresses

Primary practice location

16601 E Centretech Pkwy
Aurora, CO 80011-9045

Mailing address

16601 E Centretech Pkwy
Aurora, CO 80011-9045
Phone (303) 739-4936

Other identifiers 1

IdentifierTypeStateIssuer
015545OtherCOKAISER

Other names 1

  • Dr. Xoa T Nguyen Former name

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)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
18109COMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1258329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617062400000",
    "number": "1831426634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16601 E CENTRETECH PKWY",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800119045",
            "telephone_number": "303-739-4936",
            "fax_number": "303-739-4927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16601 E CENTRETECH PKWY",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800119045",
            "telephone_number": "303-739-4936",
            "fax_number": "303-739-4936"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNGBLOOD",
        "first_name": "XOA",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "PHARM. D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-11-16",
        "last_updated": "2021-03-30",
        "certification_date": "2021-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CO",
            "license": "18109",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KAISER",
            "identifier": "015545",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "XOA",
            "last_name": "NGUYEN",
            "middle_name": "T",
            "prefix": "DR.",
            "credential": "PHARM. D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Aurora, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2021; 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.