Cathy Evans Longos, DMD

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

021001620 Issued in IL

Practice address

22A Glen Ed Professional Park
Glen Carbon, IL 62034

Phone

(618) 656-7615

NPI assigned

Dec 13, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Catherine Elizabeth Evans Former name

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466467200000",
    "number": "1114088812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22A GLEN ED PROFESSIONAL PARK",
            "city": "GLEN CARBON",
            "state": "IL",
            "postal_code": "62034",
            "telephone_number": "618-656-7615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22A GLEN ED PROFESSIONAL PARK",
            "city": "GLEN CARBON",
            "state": "IL",
            "postal_code": "62034",
            "telephone_number": "618-656-7615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONGOS",
        "first_name": "CATHY",
        "middle_name": "EVANS",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-13",
        "last_updated": "2016-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019021729",
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "IL",
            "license": "021001620",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CATHERINE",
            "last_name": "EVANS",
            "middle_name": "ELIZABETH",
            "credential": "DMD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Endodontics in Glen Carbon, IL
• Providers in Glen Carbon, IL by specialty
• Endodontics in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.