Prabha Jaishwal Long (NPI# 1760965628, PAC ID# 8729331236) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
| Nation Provider ID (NPI) | 1760965628 |
| PAC ID by PECOS | 8729331236 |
| Professional Enrollment ID | I20181031001342 |
| Full Name | Prabha Jaishwal Long |
| Organization Legal Name | BLUE RIDGE MEDICAL MANAGEMENT CORPORATION |
| Address |
1505 W Elk Ave Suite 2 Elizabethton TN 37643-2848 |
| Phone Number | 4235431261 |
| Gender | F |
| Medical School | EAST CAROLINA UNIVERSITY SCHOOL OF MEDICINE |
| Graduation Year | 2014 |
| Primary Specialty | NURSE PRACTITIONER |
| Group Practice PAC ID | 9739099441 |
| Number of Group Practice Members | 316 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 440018 | SYCAMORE SHOALS HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 1505 W Elk Ave, Suite 2, Elizabethton, TN 37643-2848 | 4235431261 | BLUE RIDGE MEDICAL MANAGEMENT CORPORATION |
| Organization Legal Name | BLUE RIDGE MEDICAL MANAGEMENT CORPORATION |
| Physicians | 289 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Deneene R Booth | Anesthesiology | Blue Ridge Medical Management Corporation | 601 Campus Dr, Abingdon, VA 24210-9700 |
| Shasta Nicole Bowens | Nurse Practitioner | Blue Ridge Medical Management Corporation | 2000 Brookside Dr, Suite 3, Kingsport, TN 37660-4627 |
| Luc Jasmin | Neurosurgery | Blue Ridge Medical Management Corporation | 701 Med Tech Pkwy, Suite 300, Johnson City, TN 37604-2365 |
| Sandra Michelle Sparks | Nurse Practitioner | Blue Ridge Medical Management Corporation | 310 N State of Franklin Rd, Suite 400, Johnson City, TN 37604-6529 |
| Rebecca Sacora | Family Medicine | Blue Ridge Medical Management Corporation | 2030 Temple Hill Rd, Suite B, Erwin, TN 37650-8721 |
| Leslie Renee Barlow | Nurse Practitioner | Blue Ridge Medical Management Corporation | 1201 Snider St, Marion, VA 24354-4221 |
| Sheila Ann Matherly | Nurse Practitioner | Blue Ridge Medical Management Corporation | 404 Bemberg Rd, Elizabethton, TN 37643-2938 |
| Melanie Hagerman | Nurse Practitioner | Blue Ridge Medical Management Corporation | 2 Professional Park Dr, Suite 11, Johnson City, TN 37604-6584 |
| Jessica Glasscock Mcgahey | Nurse Practitioner | Blue Ridge Medical Management Corporation | 400 N State of Franklin, Room Lk015, Johnson City, TN 37604-0000 |
| Amanda Elizabeth Loughlin | Nurse Practitioner | Blue Ridge Medical Management Corporation | 71 S Flannagan Ave, Lebanon, VA 24266 |
| Street Address |
1505 W ELK AVE SUITE 2 |
| City | ELIZABETHTON |
| State | TN |
| Zip | 37643-2848 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jessica R Odell | Nurse Practitioner | Blue Ridge Medical Management Corporation | 1505 W Elk Ave, Suite 2, Elizabethton, TN 37643-2848 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Robert Sams | Optometry | 114 S Sycamore St, Elizabethton, TN 37643-0001 | |
| Ashley C Baker | Optometry | Family Eyecare Center, Pllc | 629 Broad St, Elizabethton, TN 37643-2221 |
| Victoria Ashley Howard | Optometry | Family Eyecare Center, Pllc | 629 Broad St, Elizabethton, TN 37643-2221 |
| John Francis Holland | Optometry | Family Eyecare Center, Pllc | 629 Broad St, Elizabethton, TN 37643-2221 |
| Stephen Edward Wheeler | Chiropractic | 835 Broad St, Elizabethton, TN 37643-2312 | |
| Charles Peters Iii | Physical Therapy | Champion Physical Therapy LLC | 420 Railroad St, Elizabethton, TN 37643-2504 |
| Kimberly Kay Kleine | Nurse Practitioner | Shc Medical Partners of Tennessee, LLC | 1500 W Elk Ave, Suite 109, Elizabethton, TN 37643-2655 |
| Sheryl D Pack | Family Medicine | Blue Ridge Medical Management Corporation | 1497 W Elk Ave, Suite 21, Elizabethton, TN 37643-2872 |
| Anthony Tin-lung Pang-ng | Family Medicine | Tri-cities Regional Emergency Physicians, PC | 1501 W Elk Ave, Elizabethon, TN 37643-2874 |
| Pradeep Srikanthan | Family Medicine | Southeastern Physician Services PC | 1501 W Elk Ave, Elizabethon, TN 37643-2874 |
| Find all physicians in zip 37643 | |||
| City | ELIZABETHTON |
| Zip Code | 37643 |
| Specialty | NURSE PRACTITIONER |
| City + Specialty | ELIZABETHTON + NURSE PRACTITIONER |
Please comment or provide details below to improve the information on Prabha Jaishwal Long.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.