Individual provider Active NPI

Stephen N Long, MD

  • Internal Medicine Physician
  • Roxboro, NC
National Provider Identifier
1174586846
Registry record updated Feb 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
30403 Issued in NC
Practice address
783 Doctors CT
Roxboro, NC 27573-4575
Phone
(336) 599-3212
Fax
(336) 598-6025
NPI assigned
Apr 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 30403 NC Primary

Addresses

Primary practice location

783 Doctors CT
Roxboro, NC 27573-4575

Mailing address

PO Box 1058
Roxboro, NC 27573-1058
Phone (336) 598-6036

Other identifiers 1

IdentifierTypeStateIssuer
8952674MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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

Enrollment IDStateProvider typePAC IDDetails
I20100329000345 NC Practitioner - Internal Medicine 1557467354

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Wake Forest University School of Medicine, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

783 Doctors Court
Roxboro, NC 27573

PO Box
Suite 1058
Roxboro, NC 27573-1058

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
30403NCMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1144713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297468800000",
    "number": "1174586846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1058",
            "city": "ROXBORO",
            "state": "NC",
            "postal_code": "275731058",
            "telephone_number": "336-598-6036",
            "fax_number": "336-598-6025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "783 DOCTORS CT",
            "city": "ROXBORO",
            "state": "NC",
            "postal_code": "275734575",
            "telephone_number": "336-599-3212",
            "fax_number": "336-598-6025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONG",
        "first_name": "STEPHEN",
        "middle_name": "N",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-11",
        "last_updated": "2011-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "30403",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8952674",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roxboro, NC

Sources for this page

Verify at the official NPI Registry.