Albert-Mary Longchamp

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

11018757 Issued in FL

Practice address

14502 N Dale Mabry Hwy Ste 200
Tampa, FL 33618-2040

Phone

(800) 640-3451

NPI assigned

Apr 12, 2022

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1649721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707782400000",
    "number": "1386386043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "811 DATELAND RD SE",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329096681",
            "telephone_number": "954-547-9618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14502 N DALE MABRY HWY STE 200",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336182040",
            "telephone_number": "800-640-3451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONGCHAMP",
        "first_name": "ALBERT-MARY",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-04-12",
        "last_updated": "2024-02-13",
        "certification_date": "2024-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "11018757",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "11018757",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "11018757",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Kathryn Long, LMHC
• Monica Lynn Long, M.S./CCC-SLP
• Tiana Long, LMT
• Wendy Long, ARNP
• Ward G. Longbottom, M.D.
• Maliena Michi Longley, M.D.
• Robin Longley, M.D.
• Carlena Longmire, COTA/L
• John P. Longmire III, D.D.S.
• Carmen Maria Longnecker, OTRL

• Nurse Practitioner in Tampa, FL
• Providers in Tampa, FL by specialty
• Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.