Individual provider Active NPI

Allison Long

  • Occupational Therapist
  • Grand Forks, ND
National Provider Identifier
1104681097
Registry record updated Feb 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Practice address
2951 S 34TH St
Grand Forks, ND 58201-6061
Phone
(701) 772-3851
NPI assigned
Feb 19, 2024
Last updated
Feb 19, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X Primary

Addresses

Primary practice location

2951 S 34TH St
Grand Forks, ND 58201-6061

Mailing address

6532 S County Road 490 W
Paoli, IN 47454-9077

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240415003394 ND Practitioner - Occupational Therapist in Private Practice 6204275969 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2070NDMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Little Miracles, Inc. CurrentSince Mar 4, 2024 Accepting new patients

Locations

2200 Library Cir
Grand Forks, ND 58201
Phone (701) 757-2155

2951 S 34th St
Grand Forks, ND 58201
Phone (701) 772-3851

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1708300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708300800000",
    "number": "1104681097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6532 S COUNTY ROAD 490 W",
            "city": "PAOLI",
            "state": "IN",
            "postal_code": "474549077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2951 S 34TH ST",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582016061",
            "telephone_number": "701-772-3851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONG",
        "first_name": "ALLISON",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-19",
        "last_updated": "2024-02-19",
        "certification_date": "2024-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Forks, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.