MR. LARRY DAVID YOUNGBLOOD III (NPI# 1306365895) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306365895 |
| Entity Type | Individual |
| Full Name | MR. LARRY DAVID YOUNGBLOOD III |
| Credential | ATC, LAT |
| Practice Address |
251 South Clarke Street Milledgeville GA 31061-3106 |
| Mailing Address |
107 Waterbend Dr Milledgeville GA 31061-8954 |
| Practice Telephone | 4784451787 |
| Practice Fax Number | 4784451790 |
| Mailing Telephone | 4784566943 |
| Enumeration Date | 2017-09-15 |
| Last Update Date | 2017-09-15 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
AT003284 | GA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
251 SOUTH CLARKE STREET |
| City | MILLEDGEVILLE |
| State | GA |
| Zip Code | 31061-3106 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861007403 | Caring Clinic LLC | Nurse Practitioner | 114 Wrights Dr, Milledgeville, GA 31061 | 2020-09-10 |
| 1629619945 | Gini M Ellis | Counselor | Blandy Way Office Park 60, Highway 22 West, Milledgeville, GA 31061 | 2019-10-08 |
| 1356992275 | Community Health Care Systems, Inc | Clinic/Center | 100 N Abc Street, Milledgeville, GA 31061 | 2019-09-23 |
| 1467923805 | Adam Tocio | Specialist/Technologist | 350 W. Washington St., Milledgeville, GA 31061 | 2018-12-11 |
| 1487170304 | Aubrey Martin | Specialist/Technologist | 251 S Clark St., Milledgeville, GA 31061 | 2017-08-22 |
| 1427573054 | Heritagefirst Home Care Inc. | In Home Supportive Care | 1277 Twin Pine Road, Milledgeville, GA 31061 | 2017-08-04 |
| 1851813893 | Brittany Shantrel Primas | Nurse Practitioner | 102 A Airport Road Ne, Milledgeville, GA 31061 | 2017-07-12 |
| 1609300839 | Samantha Weldon | Behavioral Analyst | 174 Stewart Dr Nw, Milledgeville, GA 31061 | 2017-04-14 |
| 1427425230 | Foster Deariso | Specialist/Technologist | 251 S Clarke St, Milledgeville, GA 31061 | 2015-08-27 |
| 1023406279 | Llewelyn Garillos | Occupational Therapist | 3789 Sinclair Dam Road Ne, Milledgeville, GA 31061 | 2014-12-22 |
| Find all providers in zip 31061 | ||||
| Taxonomy Code | 2255A2300X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Specialist/Technologist |
| Specialization | Athletic Trainer |
| Athletic trainers are allied health care professionals who work in consultation with or under the direction of physicians, and specialize in the prevention, assessment, treatment and rehabilitation of injuries and illnesses. Currently, the entry-level employment requirements are a bachelor’s degree with a major in athletic training from an accredited university or college. A majority of athletic trainers hold advanced degrees. National board certification is generally required as a condition of state licensure and employment. Most states regulate athletic trainers, and they practice within the scope of that license or regulation. Clinical practice includes emergency care, rehabilitation, reconditioning, therapeutic exercise, wellness programs, exercise physiology, kinesiology, biomechanics, nutrition, psychology and health care administration. |
| Notes: Source: National Athletic Trainers’ Association (www.NATA.org) [1/1/2006: modified definition, modified source] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578195509 | Keyanna Bresha Dawson | Specialist/Technologist | 501 N Wilkinson St Apt C26, Milledgeville, GA 31061-2872 | 2020-02-07 |
| 1467923805 | Adam Tocio | Specialist/Technologist | 350 W. Washington St., Milledgeville, GA 31061 | 2018-12-11 |
| 1487170304 | Aubrey Martin | Specialist/Technologist | 251 S Clark St., Milledgeville, GA 31061 | 2017-08-22 |
| 1922557735 | Clayton Faircloth | Specialist/Technologist | 208 Ivey Dr Sw, Milledgeville, GA 31061-3760 | 2016-09-22 |
| 1629448840 | Steven Andrew Hoppenjan | Specialist/Technologist | 251 S Clarke St., Milledgeville, GA 31061-2857 | 2015-09-30 |
| 1427425230 | Foster Deariso | Specialist/Technologist | 251 S Clarke St, Milledgeville, GA 31061 | 2015-08-27 |
| 1679970545 | Sarah Fuller | Specialist/Technologist | 231 West Hancock Street, Campus Box 65, Milledgeville, GA 31061 | 2014-11-20 |
| 1306255518 | Amanda Jackson Jarriel | Specialist/Technologist | 231 West Hancock Street Campus Box 112, Georgia College, Milledgeville, GA 31061 | 2014-08-13 |
| 1164863239 | Candace A Bailey | Specialist/Technologist | 111 N Clark St, Campus Box 65, Milledgeville, GA 31061-3321 | 2013-07-17 |
| 1306190715 | Griffin Patrick Osborne | Specialist/Technologist | 108 Gmc Rd Ne, Milledgeville, GA 31061-9329 | 2012-11-07 |
| Find all providers in MILLEDGEVILLE | ||||
| City | MILLEDGEVILLE |
| Zip Code | 31061 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.