Individual provider Active NPI

Michele Lynn Long, APRN, FNP-BC

  • Family Nurse Practitioner
  • South Charleston, WV
National Provider Identifier
1295077220
Registry record updated Feb 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
63054 Issued in WV
Practice address
218 D St
South Charleston, WV 25303-3104
Phone
(304) 720-3835
Fax
(304) 720-3536
NPI assigned
Mar 15, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2025

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 63054 WV Primary

Addresses

Primary practice location

218 D St
South Charleston, WV 25303-3104

Mailing address

218 D St
South Charleston, WV 25303-3104
Phone (304) 720-3835

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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
I20140421000113 WV Practitioner - Nurse Practitioner 6305078635 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
63054WVMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Psimed, Inc. CurrentSince Apr 1, 2019 Accepting new patients
Charleston Area Medical Center Inc Past Accepting new patients
Links LLC Past Accepting new patients

Locations

1520 Kanawha Blvd E
Charleston, WV 25311
Phone (681) 265-9047

Organizations & group practices 3

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": "1363305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739318400000",
    "number": "1295077220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "218 D ST",
            "city": "SOUTH CHARLESTON",
            "state": "WV",
            "postal_code": "253033104",
            "telephone_number": "304-720-3835",
            "fax_number": "304-720-3536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "218 D ST",
            "city": "SOUTH CHARLESTON",
            "state": "WV",
            "postal_code": "253033104",
            "telephone_number": "304-720-3835",
            "fax_number": "304-720-3536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONG",
        "first_name": "MICHELE",
        "middle_name": "LYNN",
        "credential": "APRN, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-15",
        "last_updated": "2025-02-12",
        "certification_date": "2025-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WV",
            "license": "63054",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Charleston, WV

Sources for this page

Verify at the official NPI Registry.