Individual provider Active NPI

Jacqueline L Long, CRNA

  • Certified Registered Nurse Anesthetist
  • Kansas City, KS
National Provider Identifier
1194811570
Registry record updated Jul 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
55022 Issued in KS
Practice address
3901 Rainbow Blvd
Kansas City, KS 66160-8500
Phone
(913) 588-5000
NPI assigned
Oct 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 55022 KS Primary

Addresses

Primary practice location

3901 Rainbow Blvd
Kansas City, KS 66160-8500

Mailing address

PO Box 411851
Kansas City, MO 64141-1851
Phone (913) 588-5000

Other identifiers 1

IdentifierTypeStateIssuer
100417780AMedicaidKS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100616000549 KS Practitioner - Certified Registered Nurse Anesthetist (Crna) 7416087580 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kansas University Physicians IncGroup PAC ID 8921911587, 1,809 clinicians

Practice addresses (Care Compare)

10710 Nall Ave
Overland Park, KS 66211-1206
Phone (913) 588-1227

10720 Nall Ave
Overland Park, KS 66211-1206

10790 Nall Ave
Overland Park, KS 66211-1206
Phone (913) 588-1227

11300 Corporate Ave
Suite 342
Lenexa, KS 66219-1368

3901 Rainbow Blvd
Kansas City, KS 66160-7415
Phone (913) 588-3315

4000 Cambridge St
Suite G600
Kansas City, KS 66160-8501
Phone (913) 588-1227

Hospital & facility affiliations

  • University of Kansas Hospital Hospital, Kansas City, KS, CCN 170040

Merit-based Incentive Payment System (MIPS)

Final score
92.91 of 100Reported as apm
Quality
77.02
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Kansas University Physicians Inc CurrentSince Feb 12, 2014 Accepting new patients
Kansas University Physicians Inc CurrentSince Feb 12, 2014 Accepting new patients
Kansas University Physicians Inc Current Accepting new patients
Anesthesiology, Chartered Nurse Anesthetist, Certified Registered Past Accepting new patients
Topeka Anesthesia & Pain Treatment, P.a. Nurse Anesthetist, Certified Registered Past Accepting new patients
Midwestern Health Management, Inc. Past Accepting new patients

Locations

3901 Rainbow Blvd
Kansas City, KS 66160
Phone (913) 588-6005

8929 Parallel Pkwy
Kansas City, KS 66112
Phone (913) 596-3930

1700 SW 7th St
Topeka, KS 66606
Phone (785) 295-5310

Organizations & group practices 6

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 2

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": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406246400000",
    "number": "1194811570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 411851",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641411851",
            "telephone_number": "913-588-5000",
            "fax_number": "913-588-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 RAINBOW BLVD",
            "city": "KANSAS CITY",
            "state": "KS",
            "postal_code": "661608500",
            "telephone_number": "913-588-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONG",
        "first_name": "JACQUELINE",
        "middle_name": "L",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-05",
        "last_updated": "2014-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "KS",
            "license": "55022",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100417780A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2014; 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.