Individual provider Active NPI

Jalyn Monet Martin, CCC-SLP

  • Speech-Language Pathologist
  • Rock Hill, SC
National Provider Identifier
1093560179
Registry record updated Apr 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
8413 Issued in SC
Practice address
356 Oakland Ave
Rock Hill, SC 29730-4064
Phone
(803) 661-5033
NPI assigned
Apr 22, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 8413 SC Primary

Addresses

Primary practice location

356 Oakland Ave
Rock Hill, SC 29730-4064

Mailing address

356 Oakland Ave
Rock Hill, SC 29730-4064
Phone (803) 661-5033

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, NC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240514000584 SC Practitioner - Qualified Speech Language Pathologist 1052752607 Reassigns benefits to 1 organization
I20250527001481 NC Practitioner - Qualified Speech Language Pathologist 1052752607 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8413SCMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Healthcare Services Inc Speech-Language Pathologist CurrentSince May 12, 2025 Accepting new patients
Creative Health Care Management, LLC Speech-Language Pathologist CurrentSince May 1, 2024 Accepting new patients
Creative Health Care Management LLC Speech-Language Pathologist CurrentSince May 1, 2024 Accepting new patients
Legacy Healthcare Services, Inc. Speech-Language Pathologist CurrentSince May 12, 2025 Accepting new patients

Locations

10 S 9th St
Ste 4
Noblesville, IN 46060

2701 Pickett Rd
Durham, NC 27705
Phone (919) 419-4012

110 Horizon Dr
Ste 310
Raleigh, NC 27615
Phone (970) 215-3300

11951 Grandhaven Dr
Murrells Inlet, SC 29576
Phone (843) 357-0200

Organizations & group practices 4

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": "1713744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713744000000",
    "number": "1093560179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "356 OAKLAND AVE",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297304064",
            "telephone_number": "803-661-5033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "356 OAKLAND AVE",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297304064",
            "telephone_number": "803-661-5033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "JALYN",
        "middle_name": "MONET",
        "credential": "CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-04-22",
        "last_updated": "2024-04-22",
        "certification_date": "2024-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "SC",
            "license": "8413",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rock Hill, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.