Individual provider Active NPI

Sherrie R Long, NP

  • Nurse Practitioner
  • Jackson, MS
National Provider Identifier
1568533248
Registry record updated Sep 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
804367 Issued in MS
Practice address
1030 River Oaks Dr
Jackson, MS 39232-9553
Phone
(800) 893-9698
NPI assigned
Nov 13, 2006
Last updated
Sep 25, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 804367 MS Primary
Emergency Medicine Physician 207P00000X R804367 MS

Addresses

Primary practice location

1030 River Oaks Dr
Jackson, MS 39232-9553

Mailing address

200 Corporate Blvd
Lafayette, LA 70508-3870

Other practice location 1

104 Fort Hill Rd
Waverly, TN 37185-2128
Phone (731) 394-1145

Other practice location 2

823 Grand Ave
Yazoo City, MS 39194-3233
Phone (662) 746-2261

Other identifiers 1

IdentifierTypeStateIssuer
00124253MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040903000171 MS Practitioner - Nurse Practitioner 2567438336 Reassigns benefits to 8 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ultra Health LLCGroup PAC ID 6800186602, 151 clinicians
North Sunflower Medical CenterGroup PAC ID 7618932294, shared by 11 NPIs, 46 clinicians

Practice addresses (Care Compare)

1221 E Union St
Ms Care Center of Greenville
Greenville, MS 38703-3243
Phone (731) 394-1145

205 W Park Ave
Greenwood, MS 38930-3008
Phone (662) 219-2742

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R804367MSMDEmergency Medicine Physician
804367MSMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
North Sunflower Medical Center CurrentSince Feb 4, 2025 Accepting new patients
South Sunflower County Hospital Current Accepting new patients
South Sunflower County Hospital Current Accepting new patients
Coffee County Physician Group PC Emergency Medicine CurrentSince Feb 1, 2022 Accepting new patients
Yazoo Emergency Group, LLC Emergency Medicine CurrentSince Oct 14, 2019 Accepting new patients
South Sunflower County Hospital Current Accepting new patients
North Sunflower Medical Center CurrentSince Feb 4, 2024 Accepting new patients
State of Mississippi - University of Mississippi Medical Center CurrentSince Sep 12, 2018 Accepting new patients
North Sunflower Medical Center Current Accepting new patients
South Sunflower County Hospital CurrentSince Jan 1, 2018 Accepting new patients
South Sunflower County Hospital CurrentSince Jan 1, 2018 Accepting new patients
Emergency Medicine Associates of Jackson Emergency Medicine Past Accepting new patients
Mississippi Visiting Physicians, LLC Past Accepting new patients

Locations

200 Corporate Blvd
Lafayette, LA 70508

200 Corporate Blvd
Ste 201
Lafayette, LA 70508

303 Medical Center Dr
Batesville, MS 38606
Phone (662) 563-0155

1401 River Rd
Greenwood, MS 38930
Phone (662) 459-2603

121 E Baker St
Indianola, MS 38751
Phone (601) 887-3113

340 Getwell St
Marks, MS 38646
Phone (662) 326-8031

840 N Oak Ave
Ruleville, MS 38771
Phone (601) 756-2711

823 Grand Ave
Yazoo City, MS 39194
Phone (601) 746-2261

Organizations & group practices 15

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.

View all 15

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790294400000",
    "number": "1568533248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 CORPORATE BLVD",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705083870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 RIVER OAKS DR",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392329553",
            "telephone_number": "800-893-9698"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "104 Fort Hill Rd",
            "address_purpose": "LOCATION",
            "city": "Waverly",
            "state": "TN",
            "postal_code": "371852128",
            "country_code": "US",
            "telephone_number": "731-394-1145",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "823 Grand Ave",
            "address_purpose": "LOCATION",
            "city": "Yazoo City",
            "state": "MS",
            "postal_code": "391943233",
            "country_code": "US",
            "telephone_number": "662-746-2261",
            "fax_number": "662-746-4839",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LONG",
        "first_name": "SHERRIE",
        "middle_name": "R",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-13",
        "last_updated": "2026-09-25",
        "certification_date": "2026-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MS",
            "license": "804367",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MS",
            "license": "R804367",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00124253",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

Verify at the official NPI Registry.