Individual provider Active NPI

Nicole Young

  • Speech-Language Pathologist
  • Brownsburg, IN
National Provider Identifier
1144096991
Registry record updated Dec 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
22004574A Issued in IN
Practice address
2 E Tilden Dr
Brownsburg, IN 46112-1648
Phone
(317) 852-8585
NPI assigned
Dec 1, 2023
Last updated
Dec 1, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 1, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 12107176
Speech-Language Pathologist 235Z00000X 22004574A IN Primary

Addresses

Primary practice location

2 E Tilden Dr
Brownsburg, IN 46112-1648

Mailing address

2 E Tilden Dr
Brownsburg, IN 46112-1648
Phone (317) 852-8585

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240124001991 IN Practitioner - Qualified Speech Language Pathologist 5395198527 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anew Therapy and Wellness LLCGroup PAC ID 8123415312, 29 clinicians

Practice addresses (Care Compare)

1450 E Crossing Blvd
Core Therapy and Wellness Honey Cre
Terre Haute, IN 47802-5316
Phone (812) 298-8209

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22004574AINMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Anew Therapy & Wellness LLC Speech-Language Pathologist CurrentSince Feb 1, 2024 Accepting new patients
Anew Therapy & Wellness LLC Speech-Language Pathologist CurrentSince Feb 1, 2024 Accepting new patients
The Children's Theraplay Foundation, Inc. Past Accepting new patients

Locations

6900 Gray Rd
Indianapolis, IN 46237
Phone (317) 788-2500

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1701388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701388800000",
    "number": "1144096991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 E TILDEN DR",
            "city": "BROWNSBURG",
            "state": "IN",
            "postal_code": "461121648",
            "telephone_number": "317-852-8585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 E TILDEN DR",
            "city": "BROWNSBURG",
            "state": "IN",
            "postal_code": "461121648",
            "telephone_number": "317-852-8585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "NICOLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-12-01",
        "last_updated": "2023-12-01",
        "certification_date": "2023-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": "12107176",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IN",
            "license": "22004574A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brownsburg, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 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.