Active NPI
Carolyn Diane Long
- Adult Companion
- Salem, UT
National Provider Identifier
1689349078
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Companion
- Practice address
- 834 E 320 N
Salem, UT 84653-5535 - Phone
- (801) 358-9166
- NPI assigned
- Aug 9, 2021
- Last updated
- Aug 9, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Companion | 372600000X | NU | Primary |
Addresses
Primary practice location
834 E 320 N
Salem, UT 84653-5535
Mailing address
834 E 320 N
Salem, UT 84653-5535
Phone (801) 358-9166
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 167634594 | Other | UT | DRIVERS LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1628467200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1628467200000",
"number": "1689349078",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "834 E 320 N",
"city": "SALEM",
"state": "UT",
"postal_code": "846535535",
"telephone_number": "801-358-9166"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "834 E 320 N",
"city": "SALEM",
"state": "UT",
"postal_code": "846535535",
"telephone_number": "801-358-9166"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LONG",
"first_name": "CAROLYN",
"middle_name": "DIANE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-08-09",
"last_updated": "2021-08-09",
"certification_date": "2021-08-09",
"status": "A"
},
"taxonomies": [
{
"code": "372600000X",
"taxonomy_group": "",
"desc": "Adult Companion",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DRIVERS LICENSE",
"identifier": "167634594",
"state": "UT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Salem, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.