Individual provider Active NPI

Jondra Dianne Long, MS, BSN, RN

  • Registered Nurse
  • Cincinnati, OH
National Provider Identifier
1073112553
Registry record updated Oct 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
254692 Issued in OH
Practice address
3800 Victory Pkwy Unit 1
Cincinnati, OH 45207-1092
Phone
(513) 745-3802
NPI assigned
Oct 26, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 26, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 254692 OH Primary

Addresses

Primary practice location

3800 Victory Pkwy Unit 1
Cincinnati, OH 45207-1092

Mailing address

8105 Timbertree Way
West Chester, OH 45069-1605
Phone (937) 776-2685

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL LongJ16@xavier.edu

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Bachelor on Science - Nursing, Master of Science, Registered Nurse

State licenses

LicenseStateTypeSpecialty
254692OHMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1603670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603670400000",
    "number": "1073112553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8105 TIMBERTREE WAY",
            "city": "WEST CHESTER",
            "state": "OH",
            "postal_code": "450691605",
            "telephone_number": "937-776-2685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3800 VICTORY PKWY UNIT 1",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452071092",
            "telephone_number": "513-745-3802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONG",
        "first_name": "JONDRA",
        "middle_name": "DIANNE",
        "credential": "MS, BSN, RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-26",
        "last_updated": "2020-10-26",
        "certification_date": "2020-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "254692",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "LongJ16@xavier.edu",
            "affiliation": "N",
            "address_1": "3800 Victory Pkwy Unit 1",
            "city": "Cincinnati",
            "state": "OH",
            "country_code": "US",
            "postal_code": "452071092",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.