Angela L Long, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

209013742 Issued in IL

Practice address

19 Wolf Creek Dr
Dept Otolaryngology
Swansea, IL 62226-2355

Phone

(618) 235-3687

Fax

(618) 239-9492

NPI assigned

Mar 29, 2016

Last updated

Apr 21, 2025By the provider in NPPES

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IL

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

Specialty

Nurse Practitioner

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Washington University Physicians in Illinois IncGroup PAC ID 4789945163, 168 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• HSHS St Elizabeth's Hospital Hospital, O Fallon, IL, CCN 140187

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Washington University Physicians in Illinois, Inc

  • Multi-Specialty Clinic/Center
  • O'Fallon, IL
  • NPI 1477076263
  Medicare reassignment Care Compare group NPD
• Physician Services Corporation of Southern Illinois Inc.

  dba SSM Health Medical Group

  • Internal Medicine Physician
  • Mount Vernon, IL
  • NPI 1831101807
  Medicare reassignment NPD
• Washington University Physicians in Illinois, Inc

  • Multi-Specialty Clinic/Center
  • Saint Louis, MO
  • NPI 1457203135
  NPD

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

• St Elizabeths Hospital of the Hospital Sisters of the Third Order

  dba HSHS St. Elizabeth's Hospital

  • General Acute Care Hospital
  • O'Fallon, IL
  • NPI 1629057302
  Care Compare affiliation

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

{
    "created_epoch": "1459209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745193600000",
    "number": "1639532609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7412011",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606742011",
            "telephone_number": "618-235-3687",
            "fax_number": "618-239-9492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 WOLF CREEK DR",
            "address_2": "DEPT OTOLARYNGOLOGY",
            "city": "SWANSEA",
            "state": "IL",
            "postal_code": "622262355",
            "telephone_number": "618-235-3687",
            "fax_number": "618-239-9492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONG",
        "first_name": "ANGELA",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-29",
        "last_updated": "2025-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209013742",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "Y",
            "affiliationName": "Washington University",
            "address_1": "19 Wolf Creek Dr",
            "address_2": "Dept Otolaryngology",
            "city": "Swansea",
            "state": "IL",
            "country_code": "US",
            "postal_code": "622262355",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Lifespine Center Inc.
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• Cheryl Lynn Logston, LCSW
• Lori a. Lehr, Ms, LCPC
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• Pamela Mack-Rainey
• Jeffrey Michael Maher, M.D.

• Family Nurse Practitioner in Swansea, IL
• Providers in Swansea, IL by specialty
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.