Nicole Diane Long, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

NP-1171A Issued in ID

Practice address

2990 Cortez Ave
Idaho Falls, ID 83404-7554

Phone

(208) 535-0440

Fax

(208) 535-0550

NPI assigned

Jun 22, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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

Nurse Practitioner

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Florida Woman Care LLCGroup PAC ID 5395807218, 607 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Flagler Hospital Hospital, Saint Augustine, FL, CCN 100090
• AdventHealth Palm Coast Hospital, Palm Coast, FL, CCN 100118
• Baptist Health Medical Center - Jacksonville Hospital, Jacksonville, FL, CCN 100088

Merit-based Incentive Payment System (MIPS)

Final score

88.76 of 100Reported as group

Quality

84.84

Promoting interoperability

100

Improvement activities

40

Cost

77.7

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Networks

• Freedom Health HMO Network
• Optimum HealthCare HMO Network

Interoperability endpoints

• Direct secure messaging: nicole.long.2@2183.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.

• Florida Woman Care, LLC

  • Obstetrics & Gynecology Physician
  • Tampa, FL
  • NPI 1386823243
  Medicare reassignment Care Compare group
• Womencare PA

  • Specialist
  • Orlando, FL
  • NPI 1366529042
  NPD (past)

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

• Flagler Hospital Inc

  • General Acute Care Hospital
  • St Augustine, FL
  • NPI 1144211020
  Care Compare affiliation
• Flagler Hospital, Inc.

  • Urgent Care Clinic/Center
  • Saint Augustine, FL
  • NPI 1447527965

  Hospital

  Care Compare affiliation
• Memorial Hospital Flagler Inc

  • General Acute Care Hospital
  • Palm Coast, FL
  • NPI 1679678486
  Care Compare affiliation
• Southern Baptist Hospital of Florida Inc

  • General Acute Care Hospital
  • Jacksonville, FL
  • NPI 1578620449
  Care Compare affiliation

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

{
    "created_epoch": "1340323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340323200000",
    "number": "1891058939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2990 CORTEZ AVE",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047554",
            "telephone_number": "208-535-0440",
            "fax_number": "208-535-0550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2990 CORTEZ AVE",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047554",
            "telephone_number": "208-535-0440",
            "fax_number": "208-535-0550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONG",
        "first_name": "NICOLE",
        "middle_name": "DIANE",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-22",
        "last_updated": "2012-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ID",
            "license": "NP-1171A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Long Medical PLLC
• Anna Long, RD, LD
• Brittany Long, M.S., CCC-SLP
• Michael Thomas Long, DO
• Nathan D Long, OTR/L
• Arlitta Rae Longacre
• Linda B Lopez, LCSW
• Maria R Lora, BS
• Craig B Lords, D.C.
• Perry Rex Lords, OTR/L

• Family Nurse Practitioner in Idaho Falls, ID
• Providers in Idaho Falls, ID by specialty
• Family Nurse Practitioner in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2012; 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.