Active NPI
Jeanna Michelle Long, COTA/L
- Assisted Living Facility
- Sarasota, FL
National Provider Identifier
1851738900
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Assisted Living Facility
- License
- OTA10991
- Practice address
- 743 S Beneva Rd
Sarasota, FL 34231-2411 - Phone
- (941) 953-9612
- Fax
- (941) 953-9612
- NPI assigned
- May 30, 2013
- 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 |
|---|---|---|---|---|
| Assisted Living Facility | 310400000X | OTA10991 | FL | Primary |
Addresses
Primary practice location
743 S Beneva Rd
Sarasota, FL 34231-2411
Mailing address
743 S Beneva Rd
Sarasota, FL 34231-2411
Phone (941) 953-9612
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OTA10991 | FL | MD | Assisted Living Facility |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1369872000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1369872000000",
"number": "1851738900",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "743 S BENEVA RD",
"city": "SARASOTA",
"state": "FL",
"postal_code": "342312411",
"telephone_number": "941-953-9612",
"fax_number": "941-953-9612"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "743 S BENEVA RD",
"city": "SARASOTA",
"state": "FL",
"postal_code": "342312411",
"telephone_number": "941-953-9612",
"fax_number": "941-953-9612"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LONG",
"first_name": "JEANNA",
"middle_name": "MICHELLE",
"credential": "COTA/L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-05-30",
"last_updated": "2013-05-30",
"status": "A"
},
"taxonomies": [
{
"code": "310400000X",
"taxonomy_group": "",
"desc": "Assisted Living Facility",
"state": "FL",
"license": "OTA10991",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sarasota, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.