Active NPI
Jay Allen Longino, CRNFA
- Surgical Technologist
- Amarillo, TX
National Provider Identifier
1427384684
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Technologist
- License
- 577874
- Practice address
- 1901 Medi Park Dr
BLDG D Suite 2051
Amarillo, TX 79106-2110 - Phone
- (806) 359-0718
- Fax
- (806) 359-9613
- NPI assigned
- Oct 22, 2009
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Surgical Technologist | 246ZS0410X | 577874 | TX | Primary |
Addresses
Primary practice location
1901 Medi Park Dr
BLDG D Suite 2051
Amarillo, TX 79106-2110
Mailing address
1901 Medi Park Dr
BLDG D Suite 2051
Amarillo, TX 79106-2110
Phone (806) 359-0718
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 |
|---|---|---|---|
| 577874 | TX | MD | Surgical Technologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1256169600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1256169600000",
"number": "1427384684",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1901 MEDI PARK DR",
"address_2": "BLDG D SUITE 2051",
"city": "AMARILLO",
"state": "TX",
"postal_code": "791062110",
"telephone_number": "806-359-0718",
"fax_number": "806-359-9613"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1901 MEDI PARK DR",
"address_2": "BLDG D SUITE 2051",
"city": "AMARILLO",
"state": "TX",
"postal_code": "791062110",
"telephone_number": "806-359-0718",
"fax_number": "806-359-9613"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LONGINO",
"first_name": "JAY",
"middle_name": "ALLEN",
"name_prefix": "Mr.",
"credential": "CRNFA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-10-22",
"last_updated": "2009-10-22",
"status": "A"
},
"taxonomies": [
{
"code": "246ZS0410X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Other, Surgical Technologist",
"state": "TX",
"license": "577874",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Amarillo, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.