Active NPI
James Eldon Long Sr., PA-C
- Medical Physician Assistant
- Williston, FL
National Provider Identifier
1124165626
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- PA2538
- Practice address
- 300A NW 1St Ave
Williston, FL 32696-2006 - Phone
- (352) 529-0966
- Fax
- (352) 529-0967
- NPI assigned
- Jan 31, 2007
- Last updated
- Apr 29, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | PA2538 | FL | Primary |
Addresses
Primary practice location
300A NW 1St Ave
Williston, FL 32696-2006
Mailing address
300A N,W, 1St Ave
Williston, FL 32696-6262
Phone (352) 529-0966
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| Y09KU | Other | FL | BCBS |
| 004428900 | Medicaid | FL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Institute of Cardiovascular Excellence PLLC | Past | Accepting new patients | |
| CNS Holding Company LLC | Past | Accepting new patients | |
| Ocala Geriatric Services Inc | Past | Accepting new patients |
Organizations & group practices 3
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.
-
dba Williston Rural Health and Wellness Clinic
- Rural Health Clinic/Center
- Williston, FL
- NPI 1952712713
-
- Cardiovascular Disease Physician
- Ocala, FL
- NPI 1295975803
-
- Skilled Nursing Facility
- Ocala, FL
- NPI 1982750444
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170201600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1398729600000",
"number": "1124165626",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300A N,W, 1ST AVE",
"city": "WILLISTON",
"state": "FL",
"postal_code": "326966262",
"telephone_number": "352-529-0966",
"fax_number": "352-529-0967"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300A NW 1ST AVE",
"city": "WILLISTON",
"state": "FL",
"postal_code": "326962006",
"telephone_number": "352-529-0966",
"fax_number": "352-529-0967"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LONG",
"first_name": "JAMES",
"middle_name": "ELDON",
"name_prefix": "Mr.",
"name_suffix": "Sr.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-31",
"last_updated": "2014-04-29",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "FL",
"license": "PA2538",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "Y09KU",
"state": "FL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "004428900",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Williston, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.