NPIMap

Individual provider Active NPI

Jesse Long

  • Family Nurse Practitioner
  • Greenville, SC
National Provider Identifier
1730884313
Registry record updated May 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
26834 Issued in SC
Practice address
200 Patewood Dr Ste B350
Greenville, SC 29615-6337
Phone
(864) 454-4500
Fax
(864) 454-4505
NPI assigned
Apr 3, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 26834 SC Primary

Addresses

Primary practice location

200 Patewood Dr Ste B350
Greenville, SC 29615-6337

Mailing address

300 E McBee Ave FL 4
Greenville, SC 29601-2842
Phone (864) 522-8603

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230524000824 SC Practitioner - Nurse Practitioner 0749646305 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

200 Patewood Dr
Suite B350
Greenville, SC 29615-6337
Phone (864) 454-4500

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
26834SCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health University Medical Group CurrentSince May 15, 2023 Accepting new patients
Prisma Health University Medical Group CurrentSince May 15, 2023 Accepting new patients

Locations

210 Freeman Farm Rd
Duncan, SC 29334
Phone (864) 968-5123

300 E McBee Ave
Fl 4
Greenville, SC 29601
Phone (864) 522-8615

200 Patewood Dr
Ste B350
Greenville, SC 29615
Phone (864) 454-4500

2A Cleveland Ct
Greenville, SC 29607
Phone (864) 271-7761

109 Physicians Dr
Ste C
Greer, SC 29650
Phone (864) 797-8800

325 Medical Pkwy
Ste 200D
Greer, SC 29650
Phone (864) 797-9071

Interoperability endpoints

  • Direct secure messaging: jlong646769@direct.ghs.myhfn.org

Organizations & group practices 2

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.

Hospital & facility affiliations 39

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

View all 39

NPI Registry JSON

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

{
    "created_epoch": "1680480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683676800000",
    "number": "1730884313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E MCBEE AVE FL 4",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296012842",
            "telephone_number": "864-522-8603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 PATEWOOD DR STE B350",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296156337",
            "telephone_number": "864-454-4500",
            "fax_number": "864-454-4505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONG",
        "first_name": "JESSE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-04-03",
        "last_updated": "2023-05-10",
        "certification_date": "2023-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "26834",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.