Individual provider Active NPI

Nicole Young-Cline, M.A., CCC-SLP

  • Speech-Language Pathologist
  • Myrtle Beach, SC
National Provider Identifier
1710923586
Registry record updated Aug 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
3868 Issued in SC
Practice address
8703 Highway 17 Byp S
Suite I
Myrtle Beach, SC 29575-7701
Phone
(843) 457-1053
Fax
(843) 215-2910
NPI assigned
Jun 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2010

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 3868 SC Primary

Addresses

Primary practice location

8703 Highway 17 Byp S
Suite I
Myrtle Beach, SC 29575-7701

Mailing address

8703 Highway 17 Byp S
Suite I
Myrtle Beach, SC 29575-7701
Phone (843) 457-1053

Other identifiers 1

IdentifierTypeStateIssuer
SA0704MedicaidSC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111220000060 SC Practitioner - Qualified Speech Language Pathologist 1254506348 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2003
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

8703 Hwy 17 Byp S
Suite I
Myrtle Beach, SC 29575-7701
Phone (843) 457-1053

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
3868SCMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Young Talkers, LLC Speech-Language Pathologist CurrentSince Oct 28, 2011 Accepting new patients
Young Talkers, LLC Speech-Language Pathologist PastSince Oct 28, 2011 Accepting new patients

Locations

8703 Highway 17 Byp S
Ste I
Myrtle Beach, SC 29575
Phone (843) 457-1053

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.

NPI Registry JSON

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

{
    "created_epoch": "1150848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282089600000",
    "number": "1710923586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8703 HIGHWAY 17 BYP S",
            "address_2": "SUITE I",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295757701",
            "telephone_number": "843-457-1053",
            "fax_number": "843-215-2910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8703 HIGHWAY 17 BYP S",
            "address_2": "SUITE I",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295757701",
            "telephone_number": "843-457-1053",
            "fax_number": "843-215-2910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG-CLINE",
        "first_name": "NICOLE",
        "credential": "M.A., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-21",
        "last_updated": "2010-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "SC",
            "license": "3868",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SA0704",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Myrtle Beach, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2010; 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.