Individual provider Active NPI

Brie Edgerton Long, PHARM.D.

  • Pharmacist
  • Nahunta, GA
National Provider Identifier
1295453579
Registry record updated Aug 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
019522 Issued in GA
Practice address
13202 Cleveland St W
Nahunta, GA 31553-2875
Phone
(912) 462-3784
NPI assigned
Aug 22, 2022
Last updated
Aug 22, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 019522 GA Primary

Addresses

Primary practice location

13202 Cleveland St W
Nahunta, GA 31553-2875

Mailing address

13202 Cleveland St W
Nahunta, GA 31553-2875
Phone (912) 462-3784

Other practice location 1

3150 US Highway 84
Blackshear, GA 31516-4944
Phone (912) 449-1400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
019522GAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Bennetts Hometown Pharmacy- Blackshear LLC Past Accepting new patients
Pierce Family Pharmacy Inc Past Accepting new patients
Bennett's Hometown Pharmacy, LLC PastSince Aug 28, 2022 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1661126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661126400000",
    "number": "1295453579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13202 CLEVELAND ST W",
            "city": "NAHUNTA",
            "state": "GA",
            "postal_code": "315532875",
            "telephone_number": "912-462-3784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13202 CLEVELAND ST W",
            "city": "NAHUNTA",
            "state": "GA",
            "postal_code": "315532875",
            "telephone_number": "912-462-3784"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3150 US Highway 84",
            "address_purpose": "LOCATION",
            "city": "Blackshear",
            "state": "GA",
            "postal_code": "315164944",
            "country_code": "US",
            "telephone_number": "912-449-1400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LONG",
        "first_name": "BRIE",
        "middle_name": "EDGERTON",
        "credential": "PHARM.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-22",
        "last_updated": "2022-08-22",
        "certification_date": "2022-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "GA",
            "license": "019522",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nahunta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.