Individual provider Active NPI

Nina Rae Long, CRNP

  • Family Nurse Practitioner
  • Cullman, AL
National Provider Identifier
1205691367
Registry record updated Feb 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1-171850 Issued in AL
Practice address
1809 Kress St
Cullman, AL 35058-1565
Phone
(256) 739-1210
Fax
(256) 739-1204
NPI assigned
Feb 19, 2024
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
Family Nurse Practitioner 363LF0000X 1-171850 AL Primary

Addresses

Primary practice location

1809 Kress St
Cullman, AL 35058-1565

Mailing address

491 Sherwood PL
Haleyville, AL 35565-6958
Phone (205) 485-4615

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20240528000352 AL Practitioner - Nurse Practitioner 9739521436 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Central Neurology Associates,PCGroup PAC ID 2668413451, 4 clinicians

Practice addresses (Care Compare)

1809 Kress St
Cullman, AL 35058-1565
Phone (256) 739-1210

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
North Central Neurology Associates, PC CurrentSince Apr 2, 2024 Accepting new patients

Locations

1809 Kress St
Cullman, AL 35058
Phone (256) 739-1210

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 and National Provider Directory roles.

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": "1205691367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "491 SHERWOOD PL",
            "city": "HALEYVILLE",
            "state": "AL",
            "postal_code": "355656958",
            "telephone_number": "205-485-4615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1809 KRESS ST",
            "city": "CULLMAN",
            "state": "AL",
            "postal_code": "350581565",
            "telephone_number": "256-739-1210",
            "fax_number": "256-739-1204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONG",
        "first_name": "NINA",
        "middle_name": "RAE",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-19",
        "last_updated": "2024-02-19",
        "certification_date": "2024-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-171850",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cullman, AL

Sources for this page

Verify at the official NPI Registry.