Individual provider Active NPI

Jennifer Allen Long, R.N.C.,W.H.N.P.

  • Obstetrics & Gynecology Nurse Practitioner
  • Bossier City, LA
National Provider Identifier
1164515169
Registry record updated Mar 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology Nurse PractitionerTaxonomy code 363LX0001X
License
AP04141 Issued in LA
Practice address
2449 Hospital Dr Ste 260
Bossier City, LA 71111-1909
Phone
(318) 212-7840
Fax
(318) 212-7845
NPI assigned
Oct 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Nurse Practitioner 363LX0001X RN071817 AP04141 LA
Obstetrics & Gynecology Nurse Practitioner 363LX0001X AP04141 LA Primary

Addresses

Primary practice location

2449 Hospital Dr Ste 260
Bossier City, LA 71111-1909

Mailing address

2449 Hospital Dr Ste 260
Bossier City, LA 71111-1909
Phone (318) 212-7840

Other practice location 1

431 Homer Rd
Minden, LA 71055-2933
Phone (318) 377-8855

Other practice location 2

2400 Hospital Dr Ste 400
Bossier City, LA 71111-2401
Phone (318) 212-7973

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://www.mettles.com/ Other

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050511000753 LA Practitioner - Nurse Practitioner 6002856705 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
WK Bossier OB-GYNGroup PAC ID 5597788018, 6 clinicians

Practice addresses (Care Compare)

2449 Hospital Dr
Suite 260
Bossier City, LA 71111-2399
Phone (318) 212-7840

Hospital & facility affiliations

  • Willis Knighton Medical Center Hospital, Shreveport, LA, CCN 190111
  • Minden Medical Center Hospital, Minden, LA, CCN 190144

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP04141LAMDObstetrics & Gynecology Nurse Practitioner
RN071817 AP04141LAMDObstetrics & Gynecology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
L Gregory Blanton MD and Willis Knighton Medical Ctr Current Accepting new patients
WK Bossier OB-GYN CurrentSince Apr 1, 2025 Accepting new patients

Locations

2449 Hospital Dr
Ste 260
Bossier City, LA 71111
Phone (318) 212-7840

1202 Louisiana Ave
Shreveport, LA 71101
Phone (318) 212-8946

Interoperability endpoints

  • Direct secure messaging: jlong@direct.wkhs.com

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741219200000",
    "number": "1164515169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2449 HOSPITAL DR STE 260",
            "city": "BOSSIER CITY",
            "state": "LA",
            "postal_code": "711111909",
            "telephone_number": "318-212-7840",
            "fax_number": "318-212-7845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2449 HOSPITAL DR STE 260",
            "city": "BOSSIER CITY",
            "state": "LA",
            "postal_code": "711111909",
            "telephone_number": "318-212-7840",
            "fax_number": "318-212-7845"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "431 Homer Rd",
            "address_purpose": "LOCATION",
            "city": "Minden",
            "state": "LA",
            "postal_code": "710552933",
            "country_code": "US",
            "telephone_number": "318-377-8855",
            "fax_number": "318-377-8804",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2400 Hospital Dr Ste 400",
            "address_purpose": "LOCATION",
            "city": "Bossier City",
            "state": "LA",
            "postal_code": "711112401",
            "country_code": "US",
            "telephone_number": "318-212-7973",
            "fax_number": "318-212-7836",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LONG",
        "first_name": "JENNIFER",
        "middle_name": "ALLEN",
        "name_prefix": "Mrs.",
        "credential": "R.N.C.,W.H.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-02",
        "last_updated": "2025-03-06",
        "certification_date": "2025-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "LA",
            "license": "RN071817 AP04141",
            "primary": false
        },
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "LA",
            "license": "AP04141",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.mettles.com/",
            "affiliation": "N",
            "endpointDescription": "2.16.840.1.113883.3.6037.1",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "10320 Little Patuxent Pkwy Ste 233-02",
            "city": "Columbia",
            "state": "MD",
            "country_code": "US",
            "postal_code": "210443313",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bossier City, LA

Sources for this page

Verify at the official NPI Registry.