Melodie Ann Long, CPHT

Primary specialty

Pharmacy TechnicianTaxonomy code 183700000X

License

0000026120 Issued in TN

Practice address

1212 State St
White Pine, TN 37890-3467

Phone

(865) 674-7517

Fax

(865) 674-8198

NPI assigned

May 28, 2021

Sex

Female

Sole proprietor

No

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.

• K VA T Food Stores Inc

  • Community/Retail Pharmacy
  • White Pine, TN
  • NPI 1063439412
  NPD (past)
• K VA T Food Stores Inc

  • Community/Retail Pharmacy
  • Huntsville, AL
  • NPI 1245038512
  NPD (past)

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on May 28, 2021.

{
    "created_epoch": "1622160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622160000000",
    "number": "1891361069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1212 STATE ST",
            "city": "WHITE PINE",
            "state": "TN",
            "postal_code": "378903467",
            "telephone_number": "865-674-7517",
            "fax_number": "865-674-8198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1212 STATE ST",
            "city": "WHITE PINE",
            "state": "TN",
            "postal_code": "378903467",
            "telephone_number": "865-674-7517",
            "fax_number": "865-674-8198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONG",
        "first_name": "MELODIE",
        "middle_name": "ANN",
        "credential": "CPHT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-28",
        "last_updated": "2021-05-28",
        "certification_date": "2021-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183700000X",
            "taxonomy_group": "",
            "desc": "Pharmacy Technician",
            "state": "TN",
            "license": "0000026120",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• K VA T Food Stores Inc
• Joshua Keathley
• Kathy Burdick Lane, PT
• Jada Lewis, LMFT
• Donna I Litteral, M.S.
• Alex J. Miller, DDS
• Peak Rehab
• Brooklyn Potter
• Taylor Ruth Reed, DPT
• Whitney Briann Rogers, RBT

• All providers in White Pine, TN
• Pharmacy Technician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2021; 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.