Individual provider Active NPI

Angelica Tashay Young, DNP-C

  • Family Nurse Practitioner
  • Moncks Corner, SC
National Provider Identifier
1619769734
Registry record updated May 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F05250575 Issued in SC
Practice address
254 Gulledge St
Moncks Corner, SC 29461-3558
Phone
(843) 870-2794
NPI assigned
May 22, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F05250575 SC Primary

Addresses

Primary practice location

254 Gulledge St
Moncks Corner, SC 29461-3558

Mailing address

254 Gulledge St
Moncks Corner, SC 29461-3558

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250817000036 SC Practitioner - Nurse Practitioner 4789183757 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

254 Gulledge St
Moncks Corner, SC 29461-3558

350 Bedford St
Suite 406a
Stamford, CT 06901-1738

677 Broadway
Suite 7
Albany, NY 12207-2553

Hospital & facility affiliations

  • Amedisys Home Health of Charleston East Home health agency, Charleston, SC, CCN 427027
  • Centerwell Home Health Home health agency, North Charleston, SC, CCN 427035
  • Interim Healthcare Home health agency, North Charleston, SC, CCN 427132
  • Novant Health East Cooper Medical Center Hospital, Mount Pleasant, SC, CCN 420089

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F05250575SCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Physicians Services Group, P.C. CurrentSince Aug 6, 2025 Accepting new patients
Psgsc MSSP, P.C. CurrentSince Sep 28, 2025 Accepting new patients
Careconnectmd South Carolina P.C. CurrentSince Sep 1, 2025 Accepting new patients

Locations

3090 Bristol St
Ste 200
Costa Mesa, CA 92626
Phone (714) 992-1182

8595 Pelham Rd
Ste 400
Greenville, SC 29615
Phone (864) 316-8984

8595 Pelham Rd
Ste 400320
Greenville, SC 29615

2 Griffith Rd
Greenville, SC 29607
Phone (864) 276-8583

1240 Winnowing Way
Unit 102
Mt Pleasant, SC 29466
Phone (828) 396-5634

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 and National Provider Directory roles.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1747872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747872000000",
    "number": "1619769734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "254 GULLEDGE ST",
            "city": "MONCKS CORNER",
            "state": "SC",
            "postal_code": "294613558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "254 GULLEDGE ST",
            "city": "MONCKS CORNER",
            "state": "SC",
            "postal_code": "294613558",
            "telephone_number": "843-870-2794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "ANGELICA",
        "middle_name": "TASHAY",
        "name_prefix": "Dr.",
        "credential": "DNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-05-22",
        "last_updated": "2025-05-22",
        "certification_date": "2025-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "F05250575",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moncks Corner, SC

Sources for this page

Verify at the official NPI Registry.