Individual provider Active NPI

Amanda J Long, AUD

  • Audiologist
  • Hanover, PA
National Provider Identifier
1457442386
Registry record updated May 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
AT001154L Issued in PA
Practice address
600 Carlisle St Ste a
Hanover, PA 17331-5100
Phone
(717) 632-5558
Fax
(717) 632-7493
NPI assigned
Sep 27, 2006
Last updated
May 24, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X AT001154L PA Primary

Addresses

Primary practice location

600 Carlisle St Ste a
Hanover, PA 17331-5100

Mailing address

600 Carlisle St Ste a
Hanover, PA 17331-5100
Phone (717) 632-5558

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081027000222 PA Practitioner - Qualified Audiologist 1951469535 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2007
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2030 Thistle Hill Dr
Suite 207
Spring Grove, PA 17362-1161
Phone (717) 739-8340

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
AT001154LPAMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Jmdlad Inc. CurrentSince May 28, 2023 Accepting new patients
Jmdlad Inc. Audiologist CurrentSince Nov 1, 2021 Accepting new patients

Locations

39 N Washington St
Ste 2
Gettysburg, PA 17325
Phone (717) 400-5558

600 Carlisle St
Hanover, PA 17331
Phone (717) 632-5558

600 Carlisle St
Ste 1
Hanover, PA 17331

600 Carlisle St
Ste A
Hanover, PA 17331
Phone (717) 632-5558

2030 Thistle Hill Dr
Ste 207
Spring Grove, PA 17362
Phone (717) 739-8340

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684886400000",
    "number": "1457442386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 CARLISLE ST STE A",
            "city": "HANOVER",
            "state": "PA",
            "postal_code": "173315100",
            "telephone_number": "717-632-5558",
            "fax_number": "717-632-7493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 CARLISLE ST STE A",
            "city": "HANOVER",
            "state": "PA",
            "postal_code": "173315100",
            "telephone_number": "717-632-5558",
            "fax_number": "717-632-7493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONG",
        "first_name": "AMANDA",
        "middle_name": "J",
        "credential": "AUD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-27",
        "last_updated": "2023-05-24",
        "certification_date": "2023-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "PA",
            "license": "AT001154L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hanover, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.