Active NPI
Cynthia Diana Long
- Adult Companion
- Calhoun, GA
National Provider Identifier
1568217578
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Companion
- License
- PHCP013061
- Practice address
- 132 Pin Oak LN SE
Calhoun, GA 30701-4090 - Phone
- (678) 451-5028
- NPI assigned
- Apr 22, 2024
- Last updated
- Apr 22, 2024
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Adult Companion | 372600000X | PHCP013061 | GA | Primary |
Addresses
Primary practice location
132 Pin Oak LN SE
Calhoun, GA 30701-4090
Mailing address
132 Pin Oak LN SE
Calhoun, GA 30701-4090
Phone (678) 451-5028
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 |
|---|---|---|---|
| PHCP013061 | GA | MD | Adult Companion |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1713744000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1713744000000",
"number": "1568217578",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "132 PIN OAK LN SE",
"city": "CALHOUN",
"state": "GA",
"postal_code": "307014090",
"telephone_number": "678-451-5028"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "132 PIN OAK LN SE",
"city": "CALHOUN",
"state": "GA",
"postal_code": "307014090",
"telephone_number": "678-451-5028"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LONG",
"first_name": "CYNTHIA",
"middle_name": "DIANA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-04-22",
"last_updated": "2024-04-22",
"certification_date": "2024-04-22",
"status": "A"
},
"taxonomies": [
{
"code": "372600000X",
"taxonomy_group": "",
"desc": "Adult Companion",
"state": "GA",
"license": "PHCP013061",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Calhoun, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.