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YOUNGERSELFMD
NPI 1548918196
Internal Medicine - Nephrology in Kennesaw, GA

Active since March 14, 2022CLIA 11D2256255 · Waiver
3105 CREEKSIDE VILLAGE DR NW STE 801, KENNESAW, GA 30144(781) 475-2735 Get Directions Write a Review

NPPES record last updated: July 14, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jul 14, 2023, Oct 31, 2022 (2 updates tracked since 2022).

About Youngerselfmd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

YOUNGERSELFMD (NPI 1548918196) is a healthcare organization registered as a nephrology in Kennesaw, Georgia and active in the NPI registry since March 2022. The organization holds a CLIA Waiver certificate valid through March 21, 2028 and lists Ndidiamaka O Obadan, Medical Director, as its authorized official.

NPPES Registry Identity

NPI1548918196
Entity TypeOrganization
Primary Taxonomy207RN0300X
Legal Business NameYOUTHFULMD INTEGRATIVE HEALTH LLC
Location Address3105 CREEKSIDE VILLAGE DR NW STE 801Kennesaw, GA 30144-4218
Mailing Address3105 Creekside Village Dr Nw Ste 801Kennesaw, GA 30144-4218 · (781) 475-2735
Phone(781) 475-2735
Organization SubpartNo
Authorized OfficialNdidiamaka O ObadanMedical Director · (781) 475-2735
Enumeration DateMarch 14, 2022
Last NPPES UpdateJuly 14, 20232 updates tracked since enumeration
NPPES CertifiedJuly 14, 2023
✔ NPI 1548918196 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 5

★ Primary SpecialtyInternal Medicine · NephrologyAllopathic & Osteopathic Physicians
Taxonomy Code207RN0300X
Definition
An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.
Also ListedInternal MedicineTaxonomy 207R00000X
Also ListedInternal Medicine · Hypertension SpecialistTaxonomy 207RH0005X
Also ListedInternal Medicine · Infectious DiseaseTaxonomy 207RI0200X
Also ListedHospitalistTaxonomy 208M00000X
3105 CREEKSIDE VILLAGE DR NW STE 801, Kennesaw, GA 30144
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Other Names 1

Doing Business AsYoungerselfmd

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 11D2256255

Youngerselfmd · Kennesaw, GA
Active · expires Mar 21, 2028
CLIA Number11D2256255
Laboratory TypePhysician Office
Certificate Effective DateMarch 22, 2026
Certificate Expiration DateMarch 21, 2028
Laboratory DirectorNdidiamaka O. Obadan
Laboratory Phone(404) 566-4623
Laboratory LocationYoungerselfmd3105 Creekside Village Drive NW, #801, Kennesaw, GA 30144
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MARILYN DIANE PEARCE LMFT, PH.D.
Marriage & Family Therapist
3105 CREEKSIDE VILLAGE DR NW STE 801
KENNESAW, GA 30144
Cobb County (678) 468-9103
DR. NDIDIAMAKA O OBADAN M.D.,MS
Internal Medicine (Nephrology)
3105 CREEKSIDE VILLAGE DR NW STE 801
KENNESAW, GA 30144
Cobb County (404) 566-4623

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Youthfulmd Integrative Health LLC's NPI number?

The NPI number for Youthfulmd Integrative Health LLC is 1548918196. It was assigned to this organization in the NPPES registry on March 14, 2022. The provider is doing business as Youngerselfmd.

Where is Youthfulmd Integrative Health LLC located?

Youthfulmd Integrative Health LLC is located at 3105 Creekside Village Dr NW Ste 801, Kennesaw, GA 30144. The listed phone number is (781) 475-2735.

What is Youthfulmd Integrative Health LLC's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Nephrology, with taxonomy code 207RN0300X.

Does Youthfulmd Integrative Health LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 11D2256255) is associated with this NPI, valid through March 21, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Youthfulmd Integrative Health LLC was last updated on July 14, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.