LONGEVITY MEDICAL LLC NPI 1467723486

NPI Information

  • NPI: 1467723486
  • Provider Name: LONGEVITY MEDICAL LLC
  • Classification: Registered Nurse - 163WP0808X
  • Specialization: Psychiatric/Mental Health
  • Entity Type: Organization
  • Address: 1355 B LYNNFIELD RD
    STE 205
    MEMPHIS, TN
    ZIP 38119
  • Phone: (901) 440-6045

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NPI Details

LONGEVITY MEDICAL LLC is a psychiatric/mental health registered nurse in Memphis, TN. LONGEVITY MEDICAL LLC NPI is 1467723486. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1355 B LYNNFIELD RD
STE 205
MEMPHIS, TN
ZIP 38119-801
Phone: (901) 440-6045
Fax: (901) 459-3373

The provider's authorized official is Vickie D Long .
The authorized official title is Owner and has the following contact phone number (901) 440-6045.

The enumeration date for this NPI number is 1/23/2012 and was last updated on 3/11/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1163WG0600XRegistered NurseGerontologyAPN14184TENNESSEENo
2163WP0808XRegistered NursePsychiatric/Mental HealthAPN14184TENNESSEEYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11527059MEDICAIDTENNESSEE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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