Kimberley L Long, CNM

Primary specialty

Advanced Practice MidwifeTaxonomy code 367A00000X

License

RN114961 Issued in GA

Practice address

699 Church St NE
Suite 500
Marietta, GA 30060-1110

Phone

(770) 793-9750

Fax

(770) 919-0581

NPI assigned

Oct 28, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Midwife

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: klong8904@directwellstar.org

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.

• Wellstar Medical Group, LLC

  • Family Medicine Physician
  • Kennesaw, GA
  • NPI 1558664003
  Medicare reassignment NPD
• Wellstar Medical Group, LLC

  • Family Medicine Physician
  • Powder Springs, GA
  • NPI 1093011603
  NPD
• Wellstar Medical Group, LLC

  • Multi-Specialty Clinic/Center
  • Marietta, GA
  • NPI 1275992240
  NPD
• Wellstar Medical Group, LLC

  • Obstetrics & Gynecology Physician
  • Marietta, GA
  • NPI 1245539378
  NPD (past)

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

{
    "created_epoch": "1130457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458518400000",
    "number": "1073503132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "699 CHURCH ST NE",
            "address_2": "SUITE 500",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300601110",
            "telephone_number": "770-793-9750",
            "fax_number": "770-919-0581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "699 CHURCH ST NE",
            "address_2": "SUITE 500",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300601110",
            "telephone_number": "770-793-9750",
            "fax_number": "770-919-0581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONG",
        "first_name": "KIMBERLEY",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-28",
        "last_updated": "2016-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "GA",
            "license": "RN114961",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jason Lomboy, M.D.
• Manouchka Lominy, ANP
• Alfred M Long Jr., OD
• Byron A Long, MD
• Elaine Ying Long
• Lisa Long, PHARMD
• Miriam D Long
• Stephanie Diane-Hunsley Long, RPH
• Valiece Tiara Long, M.S.
• Anna Virginia Longacre, MD

• Advanced Practice Midwife in Marietta, GA
• Providers in Marietta, GA by specialty
• Advanced Practice Midwife in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.