Individual provider Active NPI

Allan Louis Long, CRNA

  • Certified Registered Nurse Anesthetist
  • Fort Wainwright, AK
National Provider Identifier
1770533317
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN521826L Issued in PA
Practice address
1060 Gaffney Rd Stop 7400
Fort Wainwright, AK 99703-5007
Phone
(907) 361-5532
NPI assigned
May 12, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 116420 AK
Certified Registered Nurse Anesthetist 367500000X RN521826L PA Primary

Addresses

Primary practice location

1060 Gaffney Rd Stop 7400
Fort Wainwright, AK 99703-5007

Mailing address

2505 Allen Adale Rd
Fairbanks, AK 99709-2581
Phone (301) 300-2077

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK, TX2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20201211000692 AK Practitioner - Certified Registered Nurse Anesthetist (Crna) 3274945456 Reassigns benefits to 2 organizations
I20240708001740 TX Practitioner - Certified Registered Nurse Anesthetist (Crna) 3274945456 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tanana Valley Clinic LLCGroup PAC ID 5698056901, 142 clinicians

Practice addresses (Care Compare)

1650 Cowles St
Fairbanks, AK 99701-5907
Phone (907) 459-3500

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.86 of 100Reported as group
Quality
94.88
Promoting interoperability
100
Improvement activities
40
Cost
79.39

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN521826LPAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Tanana Chiefs Conference CurrentSince Apr 28, 2024 Accepting new patients
Tanana Valley Clinic LLC CurrentSince Nov 1, 2020 Accepting new patients
Tanana Chiefs Conference CurrentSince Apr 28, 2024 Accepting new patients
Anesthesia Consultants of Fairbanks LLC CurrentSince Jun 1, 2024 Accepting new patients
Tanana Valley Clinic LLC CurrentSince Nov 1, 2020 Accepting new patients

Locations

1650 Cowles St
Fairbanks, AK 99701
Phone (907) 452-8181

2310 Peger Rd
Fairbanks, AK 99709
Phone (907) 458-7263

122 1st Ave
Ste 106
Fairbanks, AK 99701

1001 Noble St
Fairbanks, AK 99701
Phone (907) 276-2806

Interoperability endpoints

  • Direct secure messaging: allan.long.1@15989.direct.athenahealth.com

Organizations & group practices 5

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 1

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

NPI Registry JSON

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1770533317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2505 ALLEN ADALE RD",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997092581",
            "telephone_number": "301-300-2077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1060 GAFFNEY RD STOP 7400",
            "city": "FORT WAINWRIGHT",
            "state": "AK",
            "postal_code": "997035007",
            "telephone_number": "907-361-5532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONG",
        "first_name": "ALLAN",
        "middle_name": "LOUIS",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-12",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AK",
            "license": "116420",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "PA",
            "license": "RN521826L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wainwright, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.