Individual provider Active NPI

William Long, NP

  • Acute Care Nurse Practitioner
  • Colorado Springs, CO
National Provider Identifier
1356007355
Registry record updated Nov 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
C-APN.0003031-C-NP Issued in CO
Practice address
1400 E Boulder St Ste 500
Colorado Springs, CO 80909-5533
Phone
(719) 364-6487
NPI assigned
Nov 14, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X C-APN.0003031-C-NP CO
Acute Care Nurse Practitioner 363LA2100X C-APN.0003031-C-NP CO Primary

Addresses

Primary practice location

1400 E Boulder St Ste 500
Colorado Springs, CO 80909-5533

Mailing address

2472 Raywood VW Apt 626
Colorado Springs, CO 80920-7757
Phone (210) 213-6897

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20220607000476 CO Practitioner - Nurse Practitioner 7315325156 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Poudre Valley Medical Group LLCGroup PAC ID 9638208549, 2,425 clinicians

Practice addresses (Care Compare)

1400 E Boulder St
Suite 500 Ear Nose and Throat Clinic Mem Hosp
Colorado Springs, CO 80909-5533
Phone (719) 364-4120

Hospital & facility affiliations

  • Uch-Memorial Health System Hospital, Colorado Springs, CO, CCN 060022

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C-APN.0003031-C-NPCOMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Poudre Valley Medical Group, LLC CurrentSince Feb 14, 2022 Accepting new patients
Poudre Valley Medical Group, LLC CurrentSince Feb 14, 2022 Accepting new patients

Locations

4404 Barranca Ln
Castle Rock, CO 80104
Phone (720) 733-5260

4110 Briargate Pkwy
Ste 460
Colorado Springs, CO 80920
Phone (719) 364-6487

8890 N Union Blvd
Colorado Springs, CO 80920
Phone (719) 364-5633

1400 E Boulder St
Ste 500
Colorado Springs, CO 80909
Phone (719) 364-6487

1400 E Boulder St
Ste 500EAR
Colorado Springs, CO 80909
Phone (719) 364-4120

2695 Rocky Mountain Ave
Ste 150
Loveland, CO 80538
Phone (970) 624-2412

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.

Hospital & facility affiliations 18

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1636848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636848000000",
    "number": "1356007355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2472 RAYWOOD VW APT 626",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809207757",
            "telephone_number": "210-213-6897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 E BOULDER ST STE 500",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809095533",
            "telephone_number": "719-364-6487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONG",
        "first_name": "WILLIAM",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-11-14",
        "last_updated": "2021-11-14",
        "certification_date": "2021-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CO",
            "license": "C-APN.0003031-C-NP",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CO",
            "license": "C-APN.0003031-C-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.