Diane Long, MD

Primary specialty

SpecialistTaxonomy code 174400000X

License

15391 Issued in TN

Practice address

6215 Humphreys Blvd
Suite 500
Memphis, TN 38120-2367

Phone

(901) 682-0630

Fax

(901) 682-0635

NPI assigned

Jul 12, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Women'S Care Center of Memphis, Mpllc

  • Obstetrics & Gynecology Physician
  • Memphis, TN
  • NPI 1720151418
  Medicare reassignment NPD
• Womens Care Center of Memphis,Mpllc

  • Specialist
  • Memphis, TN
  • NPI 1073682670
  NPD

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1174558613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6215 HUMPHREYS BLVD",
            "address_2": "SUITE 500",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381202367",
            "telephone_number": "901-682-0630",
            "fax_number": "901-682-0635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6215 HUMPHREYS BLVD",
            "address_2": "SUITE 500",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381202367",
            "telephone_number": "901-682-0630",
            "fax_number": "901-682-0635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONG",
        "first_name": "DIANE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "TN",
            "license": "15391",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ariel Rebecca Long, D.O.
• Blake Elizabeth Long, O.D.
• Brian D Long, M.S.
• Christen N Long, B.S.
• Clifford Lee Long, BS
• Erica Lasha Long, MSN, APRN, PMHNP-BC
• Helen Long, CCC-SLP
• Jody G Long, LCSW
• Leslie Long, APRN
• Russell K Long

• Specialist in Memphis, TN
• Providers in Memphis, TN by specialty
• Specialist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.