Kimberley Lee Long, NP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

8349 Issued in TN

Practice address

1817 W Morris Blvd
Morristown, TN 37813-2837

Phone

(423) 581-3904

Fax

(423) 581-3904

NPI assigned

Jul 12, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TN

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Interoperability endpoints

• Direct secure messaging: kimberley.long.1@20785.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Summit Medical Group, PLLC

  • Family Medicine Physician
  • Knoxville, TN
  • NPI 1699722470
  NPD (past)

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510876800000",
    "number": "1629093828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1817 W MORRIS BLVD",
            "city": "MORRISTOWN",
            "state": "TN",
            "postal_code": "378132837",
            "telephone_number": "423-581-3904",
            "fax_number": "423-581-6120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1817 W MORRIS BLVD",
            "city": "MORRISTOWN",
            "state": "TN",
            "postal_code": "378132837",
            "telephone_number": "423-581-3904",
            "fax_number": "423-581-3904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONG",
        "first_name": "KIMBERLEY",
        "middle_name": "LEE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-12",
        "last_updated": "2017-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TN",
            "license": "8349",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5440627",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Frank B Little Jr., MD
• Jackie Allen Livesay Jr., MD
• Rebecca Grace Lloyd
• Scott Lombardi
• Cherie A Long, LCSW
• Samuel Long
• Jose Lopez-Romero, MD
• Benjamin Bahia Lotivio Jr., P.T.
• Edith Lotivio, OTR/L
• Trey Lovelace

• Pediatric Nurse Practitioner in Morristown, TN
• Providers in Morristown, TN by specialty
• Pediatric Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.