Individual provider Active NPI

Yanneth Guadalupe Longoria, WHNP

  • Women's Health Nurse Practitioner
  • Universal City, TX
National Provider Identifier
1235852864
Registry record updated Dec 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
NP258638 Issued in GA
Practice address
221 3Rd St W BLDG 1040
Lackland Medical Squadron-Randolph
Universal City, TX 78150-4800
Phone
(210) 652-1836
NPI assigned
Sep 20, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X NP258638 GA Primary

Addresses

Primary practice location

221 3Rd St W BLDG 1040
Lackland Medical Squadron-Randolph
Universal City, TX 78150-4800

Mailing address

221 3Rd St W BLDG 1040
Universal City, TX 78150-4800
Phone (210) 652-3506

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20240730004762 GA Practitioner - Nurse Practitioner 3870030588 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
NP258638GAMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Effingham Hospital, Inc. CurrentSince Jul 1, 2024 Accepting new patients
Effingham Hospital, Inc. CurrentSince Jul 1, 2024 Accepting new patients

Locations

110 Goshen Rd
Rincon, GA 31326
Phone (912) 826-1400

459 Highway 119 S
Springfield, GA 31329
Phone (912) 754-0200

459 Highway 119 S
Bldg 100
Springfield, GA 31329
Phone (912) 754-0483

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.

NPI Registry JSON

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

{
    "created_epoch": "1663632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764806400000",
    "number": "1235852864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 3RD ST W BLDG 1040",
            "city": "UNIVERSAL CITY",
            "state": "TX",
            "postal_code": "781504800",
            "telephone_number": "210-652-3506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 3RD ST W BLDG 1040",
            "address_2": "LACKLAND MEDICAL SQUADRON-RANDOLPH",
            "city": "UNIVERSAL CITY",
            "state": "TX",
            "postal_code": "781504800",
            "telephone_number": "210-652-1836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONGORIA",
        "first_name": "YANNETH",
        "middle_name": "GUADALUPE",
        "credential": "WHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-20",
        "last_updated": "2025-12-04",
        "certification_date": "2025-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "GA",
            "license": "NP258638",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Universal City, TX

Sources for this page

Verify at the official NPI Registry.