NPIMap

Individual provider Active NPI

Tracie Young, NP

  • Family Nurse Practitioner
  • Winnsboro, SC
National Provider Identifier
1306376199
Registry record updated Nov 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
20610 Issued in SC
Practice address
1136 Kincaid Bridge Rd Ste a
Winnsboro, SC 29180-7116
Phone
(803) 635-1052
Fax
(803) 712-9724
NPI assigned
Jun 14, 2017
Sex
Female
Sole proprietor
No

Organizations & group practices 9

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 6

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

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
Family Health Centers, Inc. 25 clinicians

Practice addresses (Care Compare)

3310 Magnolia St
Orangeburg, SC 29115-1466

Hospital & facility affiliations

  • Musc Medical Center Hospital, Charleston, SC, CCN 420004

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
I20170914000171 SC Practitioner - Nurse Practitioner 5092088088 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Eau Claire Cooperative Health Center ,Inc. CurrentSince Nov 14, 2022 Accepting new patients
Eau Claire Cooperative Health Center, Inc. CurrentSince Nov 14, 2022 Accepting new patients

Locations

169 Laurelhurst Ave
Columbia, SC 29210
Phone (803) 730-0742

4605 Monticello Rd
Columbia, SC 29203
Phone (803) 252-7001

1136 Kincaid Bridge Rd
#A
Winnsboro, SC 29180
Phone (803) 635-1052

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 20610 SC Primary

Addresses

NPPES NPI Registry

Primary practice location

1136 Kincaid Bridge Rd Ste a
Winnsboro, SC 29180-7116

Mailing address

500 Lakeshore Pkwy
Rock Hill, SC 29730-4273
Phone (803) 909-9751

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Nov 17, 2022.

{
    "created_epoch": "1497398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668643200000",
    "number": "1306376199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 LAKESHORE PKWY",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297304273",
            "telephone_number": "18039099751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1136 KINCAID BRIDGE RD STE A",
            "city": "WINNSBORO",
            "state": "SC",
            "postal_code": "291807116",
            "telephone_number": "803-635-1052",
            "fax_number": "803-712-9724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "TRACIE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-14",
        "last_updated": "2022-11-17",
        "certification_date": "2022-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "20610",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winnsboro, SC

Sources for this page

Verify at the official NPI Registry.