Challis Madison Long, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP139265 Issued in TX

Practice address

5615 Deauville Ste 240
Midland, TX 79706-2709

Phone

(432) 221-5560

NPI assigned

Nov 27, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: challis.long.1@9925.direct.athenahealth.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.

• Premier Family Care I, Inc

  • General Practice Physician
  • Midland, TX
  • NPI 1275522864
  NPD
• Texas Tech University Health Sciences Center Lubbock

  • Durable Medical Equipment & Medical Supplies
  • Lubbock, TX
  • NPI 1053458026
  NPD (past)
• West Texas Orthopedics LLP

  • Orthopaedic Surgery Physician
  • Midland, TX
  • NPI 1831143353
  NPD (past)

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

{
    "created_epoch": "1543276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599523200000",
    "number": "1861962391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5615 DEAUVILLE STE 240",
            "city": "MIDLAND",
            "state": "TX",
            "postal_code": "797062709",
            "telephone_number": "432-221-5560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5615 DEAUVILLE STE 240",
            "city": "MIDLAND",
            "state": "TX",
            "postal_code": "797062709",
            "telephone_number": "432-221-5560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONG",
        "first_name": "CHALLIS",
        "middle_name": "MADISON",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-27",
        "last_updated": "2020-09-08",
        "certification_date": "2020-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP139265",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "AP139265",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "challis.long.1@9925.direct.athenahealth.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "5615 Deauville Ste 240",
            "city": "Midland",
            "state": "TX",
            "country_code": "US",
            "postal_code": "797062709",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Tiffany Goran Locke, PA-C
• Daniel Lockhart
• Michael Patrick Loftis, D.C.
• Michael Walton Lee Loftis, DC
• Brittany Long
• Misty Long, MSN, APRN, CNM
• Tasha Long, RN
• Rachel Longacre, NP-C
• Amanda Lopez
• Danielle Nadine Lopez, PHLEBOTOMIST

• Family Nurse Practitioner in Midland, TX
• Providers in Midland, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.