John Joseph Longobardo, D.P.M., M.D.

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

320 Issued in NC

Practice address

531 Brookdale Dr
Statesville, NC 28677-4107

Phone

(704) 872-2028

NPI assigned

Oct 23, 2006

Last updated

Dec 13, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 12

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Podiatry

Education

Other, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Gooden Mobile Pod NC PLLCGroup PAC ID 2769738715, 16 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Aaa Family Foot Care Center,PLLC

  • Primary Podiatric Medicine Podiatrist
  • Charlotte, NC
  • NPI 1558499046
  Medicare reassignment NPD Authorized official
• Gooden Mobile Pod NC PLLC

  • Podiatrist
  • Fayetteville, NC
  • NPI 1073003752
  Medicare reassignment Care Compare group NPD
• Abc Podiatry

  • Foot Surgery Podiatrist
  • Forest City, NC
  • NPI 1861105421

  Foot & Ankle Surgery

  NPD (past)

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734048000000",
    "number": "1174606156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "531 BROOKDALE DR",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286774107",
            "telephone_number": "704-588-7373",
            "fax_number": "704-872-3390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "531 BROOKDALE DR",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286774107",
            "telephone_number": "704-872-2028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONGOBARDO",
        "first_name": "JOHN",
        "middle_name": "JOSEPH",
        "credential": "D.P.M., M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-23",
        "last_updated": "2024-12-13",
        "certification_date": "2024-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NC",
            "license": "320",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAOST PROVIDER NUMBER",
            "identifier": "22677",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRINCIPAL PROVIDER NUMBER",
            "identifier": "34811",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PPO/POS",
            "identifier": "4235524",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PD3204",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PARTNERS PROVIDER NUMBER",
            "identifier": "41856",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO PROVIDER NUMBER",
            "identifier": "2023286",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE #",
            "identifier": "2741683",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHCS PROVIDER NUMBER",
            "identifier": "56412",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890857H",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLPATH",
            "identifier": "263077",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NC BXBS PROVIDER NUMBER",
            "identifier": "0857H",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "342391",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Londry & Modlin X DDS PLLC (Statesville Dental)
• Londry & Modlin Xiv DDS PLLC (Justice Family Dentistry)
• Londry Modlin Tucker DDS PLLC (Happy Teeth)
• Katherine Hill Long, RN
• Laura Elizabeth Longino, LCSW
• Lindsay Roma Lopina, LMFTA
• Roberta Lott, LCSW
• Micaela Loudermelk, BCBA
• Gayla S Lowery, M.D.
• Elizabeth W Lowrance, FNP-C

• Foot & Ankle Surgery Podiatrist in Statesville, NC
• Providers in Statesville, NC by specialty
• Foot & Ankle Surgery Podiatrist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2024; 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.
• 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.