Individual provider Active NPI

Autumn Michelle Long Malone, OTR/L

  • Occupational Therapist
  • Greeneville, TN
National Provider Identifier
1477810729
Registry record updated Apr 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
3580 Issued in TN
Practice address
801 E McKee St
Greeneville, TN 37743-6010
Phone
(423) 638-9226
NPI assigned
Apr 11, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 3580 TN Primary

Addresses

Primary practice location

801 E McKee St
Greeneville, TN 37743-6010

Mailing address

801 E McKee St
Greeneville, TN 37743-6010
Phone (423) 638-9226

Other names 1

  • Mrs. Autumn Michelle Long Professional 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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
3580TNMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1334102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334102400000",
    "number": "1477810729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 E MCKEE ST",
            "city": "GREENEVILLE",
            "state": "TN",
            "postal_code": "377436010",
            "telephone_number": "423-638-9226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 E MCKEE ST",
            "city": "GREENEVILLE",
            "state": "TN",
            "postal_code": "377436010",
            "telephone_number": "423-638-9226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONG MALONE",
        "first_name": "AUTUMN",
        "middle_name": "MICHELLE",
        "name_prefix": "Mrs.",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-11",
        "last_updated": "2012-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TN",
            "license": "3580",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AUTUMN",
            "last_name": "LONG",
            "middle_name": "MICHELLE",
            "prefix": "MRS.",
            "credential": "OTR/L",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Greeneville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2012; 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.