NPIMap

Individual provider Active NPI

Melody Young Deangelis, APRN

  • Family Nurse Practitioner
  • Easley, SC
National Provider Identifier
1205387883
Registry record updated Oct 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
20519 Issued in SC
Practice address
115 Brushy Creek Rd
Easley, SC 29642-1120
Phone
(864) 635-0376
Fax
(864) 442-6848
NPI assigned
Oct 19, 2016
Sex
Female
Sole proprietor
No

Organizations & group practices 2

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.

Hospital & facility affiliations 39

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 39

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
CSP Enterprises LLC 12 clinicians

Practice addresses (Care Compare)

115 Brushy Creek Rd
Easley, SC 29642-1120
Phone (864) 635-0376

Hospital & facility affiliations

  • Prisma Health Greenville Memorial Hospital Hospital, Greenville, SC, CCN 420078

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
I20170110003204 SC Practitioner - Nurse Practitioner 5890076681 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
CSP Enterprises LLC Family CurrentSince Apr 1, 2020 Accepting new patients
Carolina Spine Pain LLC CurrentSince Dec 5, 2021 Accepting new patients

Locations

718 Lafayette Ave
Camden, SC 29020
Phone (803) 424-5879

1923 E Main St
Duncan, SC 29334
Phone (864) 635-0376

115 Brushy Creek Rd
Easley, SC 29642
Phone (864) 635-0376

11 Memorial Medical Dr
Greenville, SC 29605
Phone (864) 269-0404

321 S Lake Dr
Lexington, SC 29072
Phone (803) 359-9911

100 W Liberty St
Sumter, SC 29150
Phone (803) 773-0032

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 20519 SC Primary

Addresses

NPPES NPI Registry

Primary practice location

115 Brushy Creek Rd
Easley, SC 29642-1120

Mailing address

PO Box 1315
Easley, SC 29641-1315
Phone (864) 635-0376

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
NP4354MedicaidSC

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Oct 5, 2021.

{
    "created_epoch": "1476835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633392000000",
    "number": "1205387883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1315",
            "city": "EASLEY",
            "state": "SC",
            "postal_code": "296411315",
            "telephone_number": "864-635-0376",
            "fax_number": "864-442-6848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 BRUSHY CREEK RD",
            "city": "EASLEY",
            "state": "SC",
            "postal_code": "296421120",
            "telephone_number": "864-635-0376",
            "fax_number": "864-442-6848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEANGELIS",
        "first_name": "MELODY",
        "middle_name": "YOUNG",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-19",
        "last_updated": "2021-10-05",
        "certification_date": "2021-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "20519",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP4354",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Easley, SC

Sources for this page

Verify at the official NPI Registry.