NPIMap

Individual provider Active NPI

David R Long, MD

  • Family Medicine Physician
  • Lubbock, TX
National Provider Identifier
1114946480
Registry record updated Dec 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
L9785 Issued in TX
Practice address
12115 Indiana Ave
Lubbock, TX 79423-5501
Phone
(806) 531-3977
Fax
(806) 531-3978
NPI assigned
Jul 18, 2006
Last updated
Dec 14, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 14, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X L9785 TX Primary

Addresses

Primary practice location

12115 Indiana Ave
Lubbock, TX 79423-5501

Mailing address

12115 Indiana Ave
Lubbock, TX 79423-5501
Phone (806) 531-3977

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041026001146 TX Practitioner - Family Practice 8729049309 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Texas Tech University Health Science Center School of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
David R. Long M.D., P.a.Group PAC ID 5991006140, 5 clinicians

Practice addresses (Care Compare)

12115 Indiana Ave
Lubbock, TX 79423-5509
Phone (806) 531-3977

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal of nail tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
David R Long MD PA Family Medicine CurrentSince Jun 18, 2015 Accepting new patients

Locations

12115 Indiana Ave
Lubbock, TX 79423
Phone (806) 531-3977

5130 82nd St
Lubbock, TX 79424
Phone (806) 761-0275

Interoperability endpoints

  • Direct secure messaging: david.long@lch.eclinicaldirectplus.com
  • Direct secure messaging: davidr.long@direct.myteamcare.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/CFCCCD/Endpoint/CFCCCD

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607904000000",
    "number": "1114946480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12115 INDIANA AVE",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794235501",
            "telephone_number": "806-531-3977",
            "fax_number": "806-531-3978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12115 INDIANA AVE",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794235501",
            "telephone_number": "806-531-3977",
            "fax_number": "806-531-3978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONG",
        "first_name": "DAVID",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2020-12-14",
        "certification_date": "2020-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "L9785",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lubbock, TX

Sources for this page

Verify at the official NPI Registry.