Active NPI
David Quinn Youngblood
- Pharmacist
- Weiser, ID
National Provider Identifier
1982977674
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- P6013
- Practice address
- 1545 E 6TH St
Weiser, ID 83672-1495 - Phone
- (208) 549-8777
- Fax
- (208) 549-8780
- NPI assigned
- Feb 11, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | P6013 | ID | Primary |
Addresses
Primary practice location
1545 E 6TH St
Weiser, ID 83672-1495
Mailing address
1545 E 6TH St
Weiser, ID 83672-1495
Phone (208) 549-8777
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P6013 | Other | ID | STATE PHARMACIST LICENSE |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P6013 | ID | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1328918400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1328918400000",
"number": "1982977674",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1545 E 6TH ST",
"city": "WEISER",
"state": "ID",
"postal_code": "836721495",
"telephone_number": "208-549-8777",
"fax_number": "208-549-8780"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1545 E 6TH ST",
"city": "WEISER",
"state": "ID",
"postal_code": "836721495",
"telephone_number": "208-549-8777",
"fax_number": "208-549-8780"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YOUNGBLOOD",
"first_name": "DAVID",
"middle_name": "QUINN",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-02-11",
"last_updated": "2012-02-11",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "ID",
"license": "P6013",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE PHARMACIST LICENSE",
"identifier": "P6013",
"state": "ID"
}
],
"endpoints": [],
"other_names": []
}Other providers in Weiser, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.