Individual provider Active NPI

Melissa Ann Youngblood, NP

  • Family Nurse Practitioner
  • Blairsville, GA
National Provider Identifier
1841712833
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN207497 Issued in GA
Practice address
346 Deep South Farm Rd Ste a
Blairsville, GA 30512-2218
Phone
(706) 745-9417
NPI assigned
Jul 11, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN207497 GA Primary

Addresses

Primary practice location

346 Deep South Farm Rd Ste a
Blairsville, GA 30512-2218

Mailing address

346 Deep South Farm Rd, Suite a
Blairsville, GA 30512-3155
Phone (706) 745-9417

Other identifiers 1

IdentifierTypeStateIssuer
003195789BMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20180607001392 GA Practitioner - Nurse Practitioner 5496010738 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Georgia Medicine LLCGroup PAC ID 6406923739, 16 clinicians

Practice addresses (Care Compare)

346 Deep S Farm Rd
Suite a
Blairsville, GA 30512-2218
Phone (706) 745-9417

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN207497GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
North Georgia Medicine LLC CurrentSince Oct 14, 2017 Accepting new patients

Locations

346 Deep South Farm Rd
#A
Blairsville, GA 30512
Phone (706) 745-9417

123 Weaver Rd
#A
Blairsville, GA 30512
Phone (706) 745-9417

4799 Blue Ridge Dr
Ste 104
Blue Ridge, GA 30513
Phone (706) 492-3200

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 and National Provider Directory roles.

Hospital & facility affiliations 3

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": "1499731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1841712833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "346 DEEP SOUTH FARM RD, SUITE A",
            "city": "BLAIRSVILLE",
            "state": "GA",
            "postal_code": "305123155",
            "telephone_number": "706-745-9417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "346 DEEP SOUTH FARM RD STE A",
            "city": "BLAIRSVILLE",
            "state": "GA",
            "postal_code": "305122218",
            "telephone_number": "706-745-9417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNGBLOOD",
        "first_name": "MELISSA",
        "middle_name": "ANN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-11",
        "last_updated": "2022-07-21",
        "certification_date": "2021-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN207497",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003195789B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Blairsville, GA

Sources for this page

Verify at the official NPI Registry.