NPIMap

Organization Active NPI

Long Family Eye Care P.C.

  • Optometrist
  • Bloomington, IN
National Provider Identifier
1245439231
Registry record updated Dec 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
18002841B Issued in IN
Legal business name
LONG FAMILY EYE CARE P.C.
Practice address
660 S College Ave
Bloomington, IN 47403-2527
Phone
(812) 332-5090
Fax
(812) 332-5092
NPI assigned
Jul 11, 2007
Last updated
Dec 1, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2008

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

Authorized official

Name
Dr. Angela S Long, O.D.NPI 1801859657
Title
Secretary
Phone
(812) 332-5090

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152W00000X 18002841B IN Primary
OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152W00000X 18002828B IN

Addresses

Primary practice location

660 S College Ave
Bloomington, IN 47403-2527

Mailing address

660 S College Ave
Bloomington, IN 47403-2527
Phone (812) 332-5090

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110927000015 IN Part B Supplier - Clinic/Group Practice 7618087768 Receives reassigned benefits from 3 practitioners
Practice locations: Bloomington, IN

National Provider Directory

National Provider Directory

Locations

660 S College Ave
Bloomington, IN 47403
Phone (812) 332-5090

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1184112000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1228089600000",
    "number": "1245439231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "660 S COLLEGE AVE",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474032527",
            "telephone_number": "812-332-5090",
            "fax_number": "812-332-5092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "660 S COLLEGE AVE",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474032527",
            "telephone_number": "812-332-5090",
            "fax_number": "812-332-5092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LONG FAMILY EYE CARE P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-11",
        "last_updated": "2008-12-01",
        "status": "A",
        "authorized_official_last_name": "LONG",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "812-332-5090",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18002841B",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18002828B",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.