Gedeon Longtchi, FNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

R162583 Issued in MD

Practice address

2454 Vineyard LN
Crofton, MD 21114-1116

Phone

(240) 353-2357

NPI assigned

Sep 10, 2018

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in DC

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

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 and National Provider Directory roles.

• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  DC, Psychiatric/Mental Health

  Medicare reassignment NPD
• Medical Faculty Associates, Inc

  • Anesthesiology Physician
  • Washington, DC
  • NPI 1417990581

  DC

  Medicare reassignment NPD
• Wellness Health Services, LLC

  • Home Health Agency
  • Washington, DC
  • NPI 1033685953

  DC

  Medicare reassignment NPD
• Longtchi Group LLC

  • Primary Care Clinic/Center
  • Laurel, MD
  • NPI 1104567452
  NPD Authorized official
• Wellness Health Services, LLC

  • Community/Behavioral Health Agency
  • Baltimore, MD
  • NPI 1366044398

  Family

  NPD

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

{
    "created_epoch": "1536537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654041600000",
    "number": "1689157331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2454 VINEYARD LN",
            "city": "CROFTON",
            "state": "MD",
            "postal_code": "211141116",
            "telephone_number": "240-353-2357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2454 VINEYARD LN",
            "city": "CROFTON",
            "state": "MD",
            "postal_code": "211141116",
            "telephone_number": "240-353-2357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONGTCHI",
        "first_name": "GEDEON",
        "name_prefix": "Mr.",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-09-10",
        "last_updated": "2022-06-01",
        "certification_date": "2022-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "DC",
            "license": "RN1026502",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R199900",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R162583",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1689157331",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Clarissa Madison, MSW, LGSW
• Morgan Mahaffey, MA, LGPC

• All providers in Crofton, MD
• Psychiatric/Mental Health Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2022; 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.