MR. CALEB ANTHONY YOUNGBLOOD (NPI# 1235366014) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235366014 |
| Entity Type | Individual |
| Full Name | MR. CALEB ANTHONY YOUNGBLOOD |
| Credential | MMS, PA-C |
| Practice Address |
1964 W 11 Mile Rd Berkley MI 48072-3046 |
| Practice Telephone | 2485449300 |
| Mailing Telephone | 2485449300 |
| Enumeration Date | 2009-06-18 |
| Last Update Date | 2015-02-24 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
5601006038 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063657567 | Caleb Lucas Youngblood | Physical Therapist | 10701 S Ocean Dr, Lot 888, Jensen Beach, FL 34957-2641 | 2008-12-11 |
| Street Address |
1964 W 11 MILE RD |
| City | BERKLEY |
| State | MI |
| Zip Code | 48072-3046 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609082510 | Ron T Williamson Dds and Associates Plc | Dentist | 1964 W 11 Mile Rd, Suite 4, Berkley, MI 48072-3046 | 2007-05-15 |
| 1588101091 | Mark Rosen | Physician Assistant | 1964 W 11 Mile Rd, Berkley, MI 48072-3046 | 2017-01-22 |
| 1538457882 | Michigan Healthcare Professionals PC | Clinical Medical Laboratory | 1964 W 11 Mile Rd, Berkley, MI 48072-3046 | 2011-07-20 |
| 1891028759 | Ganeshji Inc | Pharmacy | 1964 W 11 Mile Rd, Berkley, MI 48072-3046 | 2009-09-10 |
| 1942444203 | Clifford M Buchman Do PC | Orthopaedic Surgery | 1964 W 11 Mile Rd, Berkley, MI 48072-3046 | 2009-04-29 |
| 1023126026 | Medcart Specialty Care LLC | Durable Medical Equipment & Medical Supplies | 1964 W 11 Mile Rd, Suite C, Berkley, MI 48072-3046 | 2006-08-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336759539 | Embodied Wellness, Pllc | Counselor | 1354 Harvard Rd, Berkley, MI 48072 | 2020-08-03 |
| 1790202224 | Medcrafters Rx Pharmacy LLC | Pharmacy | 3348 W 12 Mile Rd, Berkley, MI 48072 | 2017-08-25 |
| 1144684861 | Marilyn Ann Hawkins | Registered Nurse | 2766 West 11 Mile Rd., Beckley, MI 48072 | 2016-04-08 |
| 1134547862 | Rimma Polevoy | Internal Medicine | 1949 12 Mile Rd Ste 100, Berkley, MI 48072 | 2014-03-31 |
| 1245676212 | Chelsea Peraino Smoots | Social Worker | 892 11 Mile Rd, Berkley, MI 48072 | 2013-05-17 |
| 1770730483 | Bryce Paul Roekle | Counselor | 1799 Phillips Avenue, Berkley, MI 48072 | 2008-08-25 |
| 1003003617 | Oakland Family Services | Community/Behavioral Health | 2351 West 12 Mile Road, Berkley, MI 48072 | 2007-09-27 |
| 1063605012 | Care Plus Home Health Services, Inc | Home Health | 28139 Woodward Ave, Berkley, MI 48072 | 2007-08-23 |
| 1346370020 | David Jason Carpenter | Social Worker | 2345 West 12 Mile Road, Berkley, MI 48072 | 2007-03-06 |
| 1871674192 | Robert Igwe | Internal Medicine | 1949 West Twelve Mile Rd, Ste 200, Berkley, MI 48072 | 2006-10-17 |
| Find all providers in zip 48072 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831756717 | Colin J Colter | Physician Assistant | 1964 W 11 Mile Rd Ste 1, Berkley, MI 48072-3046 | 2019-05-25 |
| 1588101091 | Mark Rosen | Physician Assistant | 1964 W 11 Mile Rd, Berkley, MI 48072-3046 | 2017-01-22 |
| 1487936456 | Tanya S Postwaite | Physician Assistant | 27901 Woodward Ave, Suite 300, Berkley, MI 48072-0919 | 2011-09-15 |
| 1831490622 | Zhengbo Duanmu | Physician Assistant | 2905 W 12 Mile Rd, Berkley, MI 48072-1413 | 2010-11-09 |
| 1033238936 | Kenneth Jackson | Physician Assistant | 27901 Woodward Ave, Suite 300, Berkley, MI 48072-0919 | 2007-03-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023616687 | Alexandria Jaclyn Miller | Physician Assistant | 4700 Chipman Dr, Waterford, MI 48327-3413 | 2020-10-15 |
| 1639777287 | Piotr Z Purzycki | Physician Assistant | 41400 Dequindre Rd Ste 101, Sterling Heights, MI 48314-3751 | 2020-10-15 |
| 1013524859 | Amber Marie Lee | Physician Assistant | 2265 South Lindenroad, Suite A, Flint, MI 48532 | 2020-09-25 |
| 1326656844 | Dominic Farrell | Physician Assistant | 224 Portchester Rd, Holland, MI 49424-2628 | 2020-07-21 |
| 1982212072 | Alexandria Bower-nelson | Physician Assistant | 1302 Porter Drive, Charlotte, MI 48813 | 2020-07-15 |
| 1013535343 | Maria Pavia | Physician Assistant | 41302 Scarborough Ln, Novi, MI 48375-2893 | 2020-07-13 |
| 1073130241 | Kelly F Esper | Physician Assistant | 9043 Glenwood Ln, Northville, MI 48168-9129 | 2020-07-02 |
| 1811513971 | Tasha Baker | Physician Assistant | 5444 E Whitefeather Rd, Pinconning, MI 48650-8407 | 2020-06-24 |
| 1437770054 | Sterling Ryan Maxfield | Physician Assistant | 6187 Oak Grove Rd, Howell, MI 48855-8247 | 2020-05-05 |
| 1760018808 | Rachel Renee Mackmin | Physician Assistant | 41498 Mary Kay Dr, Clinton Township, MI 48038-1989 | 2020-03-20 |
| Find all providers with the same taxonomy | ||||
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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.