Active NPI
Laura L Long, RD
- Registered Dietitian
- Temperance, MI
National Provider Identifier
1184783151
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- RD86649
- Practice address
- 8765 Lewis Avenue
Temperance, MI 48182 - Phone
- (734) 847-3802
- NPI assigned
- Dec 6, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | RD86649 | MI | Primary |
Addresses
Primary practice location
8765 Lewis Avenue
Temperance, MI 48182
Mailing address
408 Deerfield Woods
Lambertville, MI 48144
Phone (734) 854-1356
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 772703126 | Medicaid | MI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RD86649 | MI | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165363200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1353024000000",
"number": "1184783151",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "408 DEERFIELD WOODS",
"city": "LAMBERTVILLE",
"state": "MI",
"postal_code": "48144",
"telephone_number": "734-854-1356"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8765 LEWIS AVENUE",
"city": "TEMPERANCE",
"state": "MI",
"postal_code": "48182",
"telephone_number": "734-847-3802"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LONG",
"first_name": "LAURA",
"middle_name": "L",
"credential": "RD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-06",
"last_updated": "2012-11-16",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "MI",
"license": "RD86649",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "772703126",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Temperance, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.