Individual provider Active NPI

Mary Caroleen Arnold Long, RN CNS

  • Clinical Nurse Specialist
  • Cincinnati, OH
National Provider Identifier
1386712958
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Nurse SpecialistTaxonomy code 364S00000X
License
COA05714NS Issued in OH
Practice address
15 W Galbraith Rd
Cincinnati, OH 45216
Phone
(513) 679-8483
Fax
(513) 984-5897
NPI assigned
Dec 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Nurse Specialist 364S00000X COA05714NS OH Primary
Clinical Nurse Specialist 364S00000X 28127221A IN

Addresses

Primary practice location

15 W Galbraith Rd
Cincinnati, OH 45216

Mailing address

4177 Eastlake Dr
Mason, OH 45040-8985
Phone (513) 398-4095

Other identifiers 1

IdentifierTypeStateIssuer
2404795MedicaidOH

Other names 1

  • Mary Caroleen Arnold Andrychuk Former name

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)
Enrolled
Credentials
Certified Nurse Specialist, Registered Nurse

State licenses

LicenseStateTypeSpecialty
28127221AINMDClinical Nurse Specialist
COA05714NSOHMDClinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
University of Cincinnati Medical Center, LLC Past Accepting new patients
West Chester Hospital LLC Past Accepting new patients
Daniel Drake Center for Post-Acute Care, LLC Past 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1386712958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4177 EASTLAKE DR",
            "city": "MASON",
            "state": "OH",
            "postal_code": "450408985",
            "telephone_number": "513-398-4095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 W GALBRAITH RD",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "45216",
            "telephone_number": "513-679-8483",
            "fax_number": "513-984-5897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARNOLD LONG",
        "first_name": "MARY",
        "middle_name": "CAROLEEN",
        "credential": "RN CNS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364S00000X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist",
            "state": "OH",
            "license": "COA05714NS",
            "primary": true
        },
        {
            "code": "364S00000X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist",
            "state": "IN",
            "license": "28127221A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2404795",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "ARNOLD ANDRYCHUK",
            "middle_name": "CAROLEEN",
            "credential": "RN CNS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Cincinnati, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.