Individual provider Active NPI

Amy C Luongo, LPN

  • Licensed Practical Nurse
  • Ellicott City, MD
National Provider Identifier
1336361112
Registry record updated Jul 10, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
66567 Issued in MA
Practice address
3300 N Ridge Rd
Suite 175
Ellicott City, MD 21043-3383
Phone
(410) 750-3474
Fax
(410) 750-3478
NPI assigned
May 2, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 10, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 66567 MA Primary

Addresses

Primary practice location

3300 N Ridge Rd
Suite 175
Ellicott City, MD 21043-3383

Mailing address

1330 Washington Dr
Annapolis, MD 21403-4731
Phone (617) 304-8879

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

LicenseStateTypeSpecialty
66567MAMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1178064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184025600000",
    "number": "1336361112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1330 WASHINGTON DR",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214034731",
            "telephone_number": "617-304-8879",
            "fax_number": "443-949-8101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 N RIDGE RD",
            "address_2": "SUITE 175",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210433383",
            "telephone_number": "410-750-3474",
            "fax_number": "410-750-3478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUONGO",
        "first_name": "AMY",
        "middle_name": "C",
        "name_prefix": "Mrs.",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-02",
        "last_updated": "2007-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "MA",
            "license": "66567",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ellicott City, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2007; 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.