Kimm Christine Long, ACCNS-AG

Primary specialty

Adult Health Clinical Nurse SpecialistTaxonomy code 364SA2200X

License

2016022480 Issued in MO

Practice address

1600 N Morley St Ste A120
Moberly, MO 65270-3685

Phone

(660) 372-9595

Fax

(660) 372-9696

NPI assigned

Jul 4, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MO

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

Specialty

Certified Clinical Nurse Specialist (CNS)

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hannibal Regional Healthcare System IncGroup PAC ID 1254236300, 256 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Hannibal Regional Hospital Hospital, Hannibal, MO, CCN 260025

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Specialist

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.fhirpoint.open.allscripts.com/fhirroute/open/10040602
• Direct secure messaging: kimm.long.p1@direct.cfmkv.nextgenshare.com

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.

• Hannibal Regional Healthcare System, Inc

  • Multi-Specialty Clinic/Center
  • Hannibal, MO
  • NPI 1134311392
  Medicare reassignment Care Compare group NPD
• Hannibal Regional Healthcare System Inc

  • Multi-Specialty Clinic/Center
  • Hannibal, MO
  • NPI 1003956095
  NPD
• Hannibal Regional Healthcare System, Inc

  • Multi-Specialty Clinic/Center
  • Kirksville, MO
  • NPI 1447789300
  NPD

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

• Hannibal Regional Healthcare System, Inc

  • Rural Acute Care Hospital
  • Hannibal, MO
  • NPI 1922042704
  Care Compare affiliation

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

{
    "created_epoch": "1467590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539734400000",
    "number": "1790137651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 N MORLEY ST",
            "city": "MOBERLY",
            "state": "MO",
            "postal_code": "652703666",
            "telephone_number": "660-372-9595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 N MORLEY ST STE A120",
            "city": "MOBERLY",
            "state": "MO",
            "postal_code": "652703685",
            "telephone_number": "660-372-9595",
            "fax_number": "660-372-9696"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1206 N Missouri St Ste C",
            "address_purpose": "LOCATION",
            "city": "Macon",
            "state": "MO",
            "postal_code": "635522150",
            "country_code": "US",
            "telephone_number": "660-395-7575",
            "fax_number": "660-665-7576",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LONG",
        "first_name": "KIMM",
        "middle_name": "CHRISTINE",
        "credential": "ACCNS-AG",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-04",
        "last_updated": "2018-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "MO",
            "license": "153901",
            "primary": false
        },
        {
            "code": "364SA2100X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Acute Care",
            "state": "MO",
            "license": "2016022480",
            "primary": false
        },
        {
            "code": "364SG0600X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Gerontology",
            "state": "MO",
            "license": "2016022480",
            "primary": false
        },
        {
            "code": "364SA2200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Adult Health",
            "state": "MO",
            "license": "2016022480",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1790137651",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Janiece Kay Linneman, LPC
• Mariah Michelle Littleton
• Loma Linda Health Care
• Loma Linda Health Care Center, L.L.C
• Betty Marie Long, MSN, DNP, FPMHNP
• Tiffany R Lopez, CPS
• Kenneth S Lorenz, MA, LMFT
• Tracie Crawford Lykins, PHARMD
• Prasanna Manjini Sengodan
• Kerri Manson

• Adult Health Clinical Nurse Specialist in Moberly, MO
• Providers in Moberly, MO by specialty
• Adult Health Clinical Nurse Specialist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2018; 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.
• 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.