Organization Active NPI

Brian K Long MD, PLLC

  • Prescribing (Medical) Psychologist
  • Statesville, NC
National Provider Identifier
1154552040
Registry record updated Jul 27, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prescribing (Medical) PsychologistTaxonomy code 103TP0016X
License
200500391 Issued in NC
Legal business name
BRIAN K LONG MD, PLLC
Practice address
211 S Center St
Suite 217-a
Statesville, NC 28677-5873
Phone
(704) 872-2350
Fax
(704) 872-2351
NPI assigned
Jul 27, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2009

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

Authorized official

Name
Dr. Brian K Long, MD
Title
Owner
Phone
(704) 872-2350

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prescribing (Medical) PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TP0016X 200500391 NC Primary

Addresses

Primary practice location

211 S Center St
Suite 217-a
Statesville, NC 28677-5873

Mailing address

211 S Center St
Suite 217-a
Statesville, NC 28677-5873
Phone (704) 872-2350

National Provider Directory

National Provider Directory

Locations

211 S Center St
Ste 217A
Statesville, NC 28677
Phone (704) 872-2350

NPI Registry JSON

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

{
    "created_epoch": "1248652800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1248652800000",
    "number": "1154552040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 S CENTER ST",
            "address_2": "SUITE 217-A",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286775873",
            "telephone_number": "704-872-2350",
            "fax_number": "704-872-2351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 S CENTER ST",
            "address_2": "SUITE 217-A",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286775873",
            "telephone_number": "704-872-2350",
            "fax_number": "704-872-2351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIAN K LONG MD, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-27",
        "last_updated": "2009-07-27",
        "status": "A",
        "authorized_official_last_name": "LONG",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "704-872-2350",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "103TP0016X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Prescribing (Medical)",
            "state": "NC",
            "license": "200500391",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Statesville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2009; 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.