Evonne Marie Long, AUD

Primary specialty

AudiologistTaxonomy code 231H00000X

License

AY1974 Issued in FL

Practice address

1010 N Davis St Ste 101
Jacksonville, FL 32209

Phone

(904) 355-3403

Fax

(904) 355-4149

NPI assigned

Sep 22, 2015

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 identifiers 2

Other names 1

• Evonne Marie Cleveland Former name

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Specialty

Qualified Audiologist

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bon Secours Medical Group Greenville Specialty Care LLCGroup PAC ID 1850779976, 290 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Bon Secours Medical Group Greenville Specialty Care LLC

  • Cardiovascular Disease Physician
  • Greenville, SC
  • NPI 1821679580
  Medicare reassignment Care Compare group NPD
• Bon Secours Medical Group Greenville Specialty Care LLC

  • Orthopaedic Surgery Physician
  • Fountain Inn, SC
  • NPI 1760361174
  NPD

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

{
    "created_epoch": "1442880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729209600000",
    "number": "1124497987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 N DAVIS ST STE 101",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322096808",
            "telephone_number": "904-355-3403",
            "fax_number": "904-355-4149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 N DAVIS ST STE 101",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32209",
            "telephone_number": "904-355-3403",
            "fax_number": "904-355-4149"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1128 N Laura St",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322064912",
            "country_code": "US",
            "telephone_number": "904-355-3403",
            "fax_number": "904-355-4149",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "115 Halton Village Cir",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "SC",
            "postal_code": "296076825",
            "country_code": "US",
            "telephone_number": "864-281-9440",
            "fax_number": "888-448-5617",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LONG",
        "first_name": "EVONNE",
        "middle_name": "MARIE",
        "credential": "AUD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-22",
        "last_updated": "2024-10-18",
        "certification_date": "2024-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "SC",
            "license": "7987",
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "FL",
            "license": "AY1974",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "019346100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSING BOARD",
            "identifier": "AY1974",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EVONNE",
            "last_name": "CLEVELAND",
            "middle_name": "MARIE",
            "credential": "AUD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Caitlin Marie Lonergan
• Ajasha Maxine Long, PHD
• Andrea Long
• Ashley Renee Long
• Brittany O'Neal Long
• Gary Long, PA
• Jennifer D Long, LMHC, MCAP
• Jessica Renee Long, APRN
• John Earl Long, MD
• Kevin R. Long, A.R.N.P.

• Audiologist in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Audiologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.