NPIMap

Individual provider Active NPI

Chasity Nicole Long, PA-C

  • Physician Assistant
  • Fayetteville, NC
National Provider Identifier
1770116931
Registry record updated Aug 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-09761 Issued in NC
Practice address
405 Owen Dr
Fayetteville, NC 28304-3411
Phone
(910) 323-3183
NPI assigned
Feb 17, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 27, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0010-09761 NC Primary

Addresses

Primary practice location

405 Owen Dr
Fayetteville, NC 28304-3411

Mailing address

405 Owen Dr
Fayetteville, NC 28304-3411
Phone (910) 323-3183

Other practice location 1

413 Owen Dr Ste 202
Fayetteville, NC 28304-3490
Phone (910) 401-5688

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20201221000970 NC Practitioner - Physician Assistant 6800208695 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Raleigh Durham Medical Group PAGroup PAC ID 2365409588, 80 clinicians
Carolina Physical Therapy Associates LLCGroup PAC ID 7012989684, shared by 7 NPIs, 496 clinicians

Practice addresses (Care Compare)

405 Owen Dr
Fayetteville, NC 28304-3411
Phone (910) 323-3183

721 Tilghman Dr
Suite 100
Dunn, NC 28334-6066
Phone (910) 892-5635

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1149607NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Raleigh Durham Medical Group PA CurrentSince Oct 1, 2024 Accepting new patients
Raleigh Durham Medical Group PA CurrentSince Oct 1, 2024 Accepting new patients
Cape Fear Family Medical Care, PA Current Accepting new patients

Locations

97 Cornerstone Dr
Cary, NC 27519
Phone (919) 460-0993

10620 Park Rd
Ste 128
Charlotte, NC 28210
Phone (704) 542-6111

413 Owen Dr
Ste 202
Fayetteville, NC 28304
Phone (910) 323-3183

405 Owen Dr
Fayetteville, NC 28304
Phone (910) 323-3183

7124 US Highway 64 E
Knightdale, NC 27545
Phone (919) 266-6211

Interoperability endpoints

  • Direct secure messaging: chasitysullivan@cffmcpa.allscriptsdirect.net

Organizations & group practices 3

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 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1581897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787788800000",
    "number": "1770116931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 OWEN DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283043411",
            "telephone_number": "910-323-3183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 OWEN DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283043411",
            "telephone_number": "910-323-3183"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "413 Owen Dr Ste 202",
            "address_purpose": "LOCATION",
            "city": "Fayetteville",
            "state": "NC",
            "postal_code": "283043490",
            "country_code": "US",
            "telephone_number": "910-401-5688",
            "fax_number": "910-491-5846",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LONG",
        "first_name": "CHASITY",
        "middle_name": "NICOLE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-02-17",
        "last_updated": "2026-08-27",
        "certification_date": "2026-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-09761",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

Verify at the official NPI Registry.