Individual provider Active NPI

Sarah Grace Youngblood, OTR/L

  • Occupational Therapist
  • Memphis, TN
National Provider Identifier
1992470082
Registry record updated Nov 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
7013 Issued in TN
Practice address
6286 Briarcrest Ave Ste 200
Memphis, TN 38120-4023
Phone
(901) 261-2506
Fax
(901) 261-2590
NPI assigned
Aug 11, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT-4007 MS
Occupational Therapist 225X00000X 7013 TN Primary

Addresses

Primary practice location

6286 Briarcrest Ave Ste 200
Memphis, TN 38120-4023

Mailing address

6077 Primacy Pkwy Ste 140
Memphis, TN 38119-5754
Phone (901) 725-8347

Other practice location 1

7580 Clarington Cv
Southaven, MS 38671-5657
Phone (901) 259-1600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, MS2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220111001451 TN Practitioner - Occupational Therapist in Private Practice 2668864265 Reassigns benefits to 1 organization
I20240111000051 MS Practitioner - Occupational Therapist in Private Practice 2668864265 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MSK Group PCGroup PAC ID 4688574262, 138 clinicians

Practice addresses (Care Compare)

2100 Exeter Rd
Suite 200
Germantown, TN 38138-3966
Phone (901) 641-3000

7580 Clarington CV
Southaven, MS 38671-5657
Phone (901) 259-1600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OT-4007MSMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
MSK Group, PC Occupational Therapist CurrentSince Jan 5, 2022 Accepting new patients
MSK Group, PC CurrentSince Jan 5, 2022 Accepting new patients
MSK Group PC Current Accepting new patients
Courageous Kids, LLC PastSince Aug 1, 2021 Accepting new patients

Locations

7580 Clarington Cv
Southaven, MS 38671
Phone (901) 259-1600

7111 Southcrest Pkwy
Ste 105
Southaven, MS 38671
Phone (901) 261-2506

2100 Exeter Rd
Ste 200
Germantown, TN 38138
Phone (901) 522-6440

6286 Briarcrest Ave
#200
Memphis, TN 38120
Phone (901) 259-1600

6077 E Primacy Pkwy
Ste 140
Memphis, TN 38119
Phone (901) 725-8347

6286 Briarcrest Ave
Ste 100
Memphis, TN 38120
Phone (901) 259-1600

6286 Briarcrest Ave
Ste 200
Memphis, TN 38120
Phone (901) 259-1600

6286 Briarcrest Ave
Ste 120
Memphis, TN 38120
Phone (901) 259-1600

Organizations & group practices 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1628640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700006400000",
    "number": "1992470082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6077 PRIMACY PKWY STE 140",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381195754",
            "telephone_number": "901-725-8347",
            "fax_number": "901-259-7637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6286 BRIARCREST AVE STE 200",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381204023",
            "telephone_number": "901-261-2506",
            "fax_number": "901-261-2590"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7580 Clarington Cv",
            "address_purpose": "LOCATION",
            "city": "Southaven",
            "state": "MS",
            "postal_code": "386715657",
            "country_code": "US",
            "telephone_number": "901-259-1600",
            "fax_number": "901-259-1698",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YOUNGBLOOD",
        "first_name": "SARAH",
        "middle_name": "GRACE",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-11",
        "last_updated": "2023-11-15",
        "certification_date": "2023-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MS",
            "license": "OT-4007",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TN",
            "license": "7013",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.