Active NPI
Laura Long
- Occupational Therapist
- Fuquay Varina, NC
National Provider Identifier
1336324938
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 7764
- Practice address
- 1221 Broad St
Fuquay Varina, NC 27526-3602 - Phone
- (800) 552-0213
- NPI assigned
- Jan 2, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 7764 | NC | Primary |
Addresses
Primary practice location
1221 Broad St
Fuquay Varina, NC 27526-3602
Mailing address
188 Susan Dr
Garner, NC 27529-9211
Phone (919) 987-0896
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 41058500 | Medicaid | WI |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7764 | NC | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1199232000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1421107200000",
"number": "1336324938",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "188 SUSAN DR",
"city": "GARNER",
"state": "NC",
"postal_code": "275299211",
"telephone_number": "919-987-0896"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1221 BROAD ST",
"city": "FUQUAY VARINA",
"state": "NC",
"postal_code": "275263602",
"telephone_number": "800-552-0213"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LONG",
"first_name": "LAURA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-01-02",
"last_updated": "2015-01-13",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NC",
"license": "7764",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "41058500",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fuquay Varina, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.