Traci Renee' Longley, OWNER/ADMINISTRATOR

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

Practice address

15595 Longspur LN.
Terrell, TX 75160

Phone

(972) 563-9045

Fax

(972) 563-9045

NPI assigned

Apr 12, 2012

Last updated

Sep 13, 2012By the provider in NPPES

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

Other names 1

• Traci Renee' Longley-Eiland Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Zoey Care

  • Home Health Agency
  • Terrell, TX
  • NPI 1518217702
  NPD (past) Authorized official

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

{
    "created_epoch": "1334188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347494400000",
    "number": "1639436934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15595 LONGSPUR LN.",
            "city": "TERRELL",
            "state": "TX",
            "postal_code": "75160",
            "telephone_number": "972-563-9045",
            "fax_number": "972-563-9045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15595 LONGSPUR LN.",
            "city": "TERRELL",
            "state": "TX",
            "postal_code": "75160",
            "telephone_number": "972-563-9045",
            "fax_number": "972-563-9045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONGLEY",
        "first_name": "TRACI",
        "middle_name": "RENEE'",
        "credential": "OWNER/ADMINISTRATOR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-04-12",
        "last_updated": "2012-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TRACI",
            "last_name": "LONGLEY-EILAND",
            "middle_name": "RENEE'",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Life Open Heart,Open Home
• Haley Lightsey
• Lindsey Alexander OD PA
• Amanda Leigh Lindsey, RN
• Michael Little, PTA
• Kaitlyn Luckey
• Martin Alan Lumpkin, PH.D.
• Paula Leann Lytle, SPEECH PATHOLOGIST
• Torrie Maae, DPT
• John J Makowski, MD

• Community Health Worker in Terrell, TX
• Providers in Terrell, TX by specialty
• Community Health Worker in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 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.