Matthew S Long, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

APN0000009329 Issued in TN

Practice address

17C Brentshire Square
Jackson, TN 38305-2273

Phone

(731) 664-1717

Fax

(731) 664-7114

NPI assigned

Aug 17, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• West Tennessee Anesthesia, PC

  • Certified Registered Nurse Anesthetist
  • Jackson, TN
  • NPI 1427137280

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD Authorized official
• Shamrock Community Hospital Inc

  • Family Medicine Physician
  • Erin, TN
  • NPI 1033878277
  Medicare reassignment NPD
• Shamrock Community Hospital Inc.

  • Medicare Defined Swing Bed Hospital Unit
  • Erin, TN
  • NPI 1952011520
  NPD
• Dr. Dennis W. Wilson

  • Clinical Psychologist
  • Murfreesboro, TN
  • NPI 1801832365
  NPD (past)

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

{
    "created_epoch": "1124236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590019200000",
    "number": "1093707945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17C BRENTSHIRE SQUARE",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383052273",
            "telephone_number": "731-664-1717",
            "fax_number": "731-664-7114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17C BRENTSHIRE SQUARE",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383052273",
            "telephone_number": "731-664-1717",
            "fax_number": "731-664-7114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONG",
        "first_name": "MATTHEW",
        "middle_name": "S",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-17",
        "last_updated": "2020-05-21",
        "certification_date": "2020-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TN",
            "license": "RN0000067803",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TN",
            "license": "RN0000057803",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "APN0000009329",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3607376",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1521318",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Levi Logan, BCBA
• Earl Wade Lomax, CRNA
• Elizabeth Londino, M.D.
• Katrina Lashelle Long
• Matt Long, B.A.
• Lucy Marie Longmire, LPN CERTIFICATION
• Majorie A Looney, CRNA
• Louviere Enterprises, Inc.
• Cierra Love Qawwi, RBT
• Gary Wayne Lovejoy, M.S.

• Certified Registered Nurse Anesthetist in Jackson, TN
• Providers in Jackson, TN by specialty
• Certified Registered Nurse Anesthetist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2020; 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.