LYSA LONG CNM NPI 1619110418

NPI Information

  • NPI: 1619110418
  • Provider Name: LYSA LONG, CNM
  • Classification: Advanced Practice Midwife - 367A00000X
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 5933 BLAKENEY PARK DR STE 100
    CHARLOTTE, NC
    ZIP 28277
  • Phone: (704) 316-2021

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NPI Details

Lysa Long, CNM is an advanced practice midwife in Charlotte, NC with 28 years of experience. The provider is advanced practice midwifery encompasses the independent provision of care during pregnancy, childbirth, and the postpartum period; sexual and reproductive health; gynecologic health; and family planning services, including preconception care. Midwives also provide primary care for individuals from adolescence throughout the lifespan as well as care for the healthy newborn during the first 28 days of life. Midwives provide initial and ongoing comprehensive assessment, diagnosis, and treatment. Midwifery care includes health promotion, disease prevention, risk assessment and management, and individualized wellness education and counseling. Source: American College of Nurse-Midwives, www.midwife.org Additional Resources: See the American College of Nurse-Midwives, www.midwife.org, for more information on Certified Nurse-Midwives, Certified Midwives, the American Midwifery Certification Board (AMCB), and licensure. Lysa Long, CNM NPI is 1619110418. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

5933 BLAKENEY PARK DR STE 100
CHARLOTTE, NC
ZIP 28277-713
Phone: (704) 316-2021
Fax: (704) 316-2025

The NPI 1619110418 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment.

The enumeration date for this NPI number is 4/9/2009 and was last updated on 10/25/2020.

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
1367A00000XAdvanced Practice Midwife185NORTH CAROLINAYes

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
17002154MEDICAIDNORTH CAROLINA

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: 3/30/2025

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