Teresa Charl Long, M.D., M.P.H.

Primary specialty

Public Health & General Preventive Medicine PhysicianTaxonomy code 2083P0901X

License

35-054074 Issued in OH

Practice address

240 Parsons Ave
Columbus, OH 43215-5331

Phone

(614) 645-7417

NPI assigned

Jul 17, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343088000000",
    "number": "1104844406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 PARSONS AVE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432155331",
            "telephone_number": "614-645-7417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 PARSONS AVE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432155331",
            "telephone_number": "614-645-7417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONG",
        "first_name": "TERESA",
        "middle_name": "CHARL",
        "credential": "M.D., M.P.H.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-17",
        "last_updated": "2012-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083P0901X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": "OH",
            "license": "35-054074",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2439730",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARESOURCE CLINIC #",
            "identifier": "316400223035",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nathaniel K Long, DO
• Rachel Long, PMHNP
• Risa Nicole Long, PHD
• Robert Long, MD
• Samar McCann Long, AT
• Valerie Lynne Long
• Victor Long III, PHARMD
• Victoria Suzanne Long, PT, DPT
• Yolanda Michelle Long
• Doris A Longalong, RN

• Public Health & General Preventive Medicine Physician in Columbus, OH
• Providers in Columbus, OH by specialty
• Public Health & General Preventive Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2012; 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.