Individual provider Active NPI

Joanne T Longbons, PA-C

  • Physician Assistant
  • Willoughby, OH
National Provider Identifier
1194944231
Registry record updated Aug 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
50.000470 Issued in OH
Practice address
36100 Euclid Avenue
Suite 170
Willoughby, OH 44094
Phone
(440) 602-6737
Fax
(440) 942-0316
NPI assigned
Apr 25, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 50.000470 OH Primary

Addresses

Primary practice location

36100 Euclid Avenue
Suite 170
Willoughby, OH 44094

Mailing address

7590 Auburn Road, Suite 014
Attn: Med Staff Services
Concord TWP, OH 44077-9176
Phone (440) 354-1899

Other identifiers 1

IdentifierTypeStateIssuer
P00829222OtherOHRAILROAD MEDICARE

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
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
50.000470OHMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Hospital System Inc CurrentSince Aug 23, 2021 Accepting new patients
Lake Hospital System, Inc CurrentSince Aug 23, 2021 Accepting new patients
Chagrin Valley Anesthesia, LLC PastSince Sep 25, 2019 Accepting new patients
CV Medical Services, LLC PastSince Sep 25, 2019 Accepting new patients

Locations

7590 Auburn Rd
Ste 14
Concord Township, OH 44077
Phone (440) 354-1899

36100 Euclid Ave
Ste 170
Willoughby, OH 44094
Phone (440) 602-6737

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1177459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628208000000",
    "number": "1194944231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7590 AUBURN ROAD, SUITE 014",
            "address_2": "ATTN: MED STAFF SERVICES",
            "city": "CONCORD TWP",
            "state": "OH",
            "postal_code": "440779176",
            "telephone_number": "440-354-1899",
            "fax_number": "440-354-1845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36100 EUCLID AVENUE",
            "address_2": "SUITE 170",
            "city": "WILLOUGHBY",
            "state": "OH",
            "postal_code": "44094",
            "telephone_number": "440-602-6737",
            "fax_number": "440-942-0316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONGBONS",
        "first_name": "JOANNE",
        "middle_name": "T",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-25",
        "last_updated": "2021-08-06",
        "certification_date": "2021-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.000470",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00829222",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Willoughby, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2021; 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.