Sally Ann Carll-Long, NP

Primary specialty

Women's Health Nurse PractitionerTaxonomy code 363LW0102X

License

169432 Issued in MA

Practice address

326 Nichols Rd
Suite 26
Fitchburg, MA 01420-1914

Phone

(978) 345-6272

NPI assigned

Feb 1, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1170288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1619015047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 TURNPIKE RD",
            "address_2": "UNIT 6",
            "city": "NEW IPSWICH",
            "state": "NH",
            "postal_code": "030713030",
            "telephone_number": "603-878-0965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "326 NICHOLS RD",
            "address_2": "SUITE 26",
            "city": "FITCHBURG",
            "state": "MA",
            "postal_code": "014201914",
            "telephone_number": "978-345-6272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLL-LONG",
        "first_name": "SALLY",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "MA",
            "license": "169432",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Women's Health Nurse Practitioner in Fitchburg, MA
• Providers in Fitchburg, MA by specialty
• Women's Health Nurse Practitioner in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.