NPIMap

Individual provider Active NPI

Ben G Long, M.D.

  • Internal Medicine Physician
  • Corinth, MS
National Provider Identifier
1255780680
Registry record updated Jun 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
LL39688 Issued in SC
Practice address
611 Alcorn Dr
Corinth, MS 38834-9388
Phone
(662) 293-1000
NPI assigned
Jun 7, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 29, 2021

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 LL39688 SC Primary

Addresses

Primary practice location

611 Alcorn Dr
Corinth, MS 38834-9388

Mailing address

1144 Peachtree St
Corinth, MS 38834-2327
Phone (662) 284-5056

Other practice location 1

96 Jonathan Lucas St
Suite 803 MSC 623
Charleston, SC 29425-8900
Phone (843) 792-2911

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address blong@magnolia.medallies.direct.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190925000748 MS Practitioner - Internal Medicine 2062700800 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Mississippi School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Magnolia Hospitalist Group 22 clinicians

Practice addresses (Care Compare)

611 Alcorn Dr
Corinth, MS 38834-9321
Phone (662) 293-1000

Hospital & facility affiliations

  • Magnolia Regional Health Center Hospital, Corinth, MS, CCN 250009
  • Tippah County Hospital Hospital, Ripley, MS, CCN 251337

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
LL39688SCMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Magnolia Regional Health Center Current Accepting new patients
Magnolia Regional Health Center Internal Medicine CurrentSince Jul 29, 2019 Accepting new patients
Magnolia Regional Health Center CurrentSince Jul 29, 2019 Accepting new patients
Magnolia Regional Health Center Current Accepting new patients
Relias Emergency Medicine Specialists of Tupelo LLC CurrentSince Jan 1, 2021 Accepting new patients
Relias Hospitalist Medicine Specialists of West Point LLC CurrentSince Dec 21, 2020 Accepting new patients
Magnolia Hospitalist Group CurrentSince Jul 29, 2019 Accepting new patients
Magnolia Regional Health Center Current Accepting new patients
Relias Hospitalist Medicine Specialists of Pontotoc LLC CurrentSince May 30, 2021 Accepting new patients

Locations

611 Alcorn Dr
Corinth, MS 38834
Phone (601) 286-6961

401 Alcorn Dr
Ste 2C
Corinth, MS 38834
Phone (662) 286-9255

176 S Main St
Pontotoc, MS 38863
Phone (601) 489-5510

830 S Gloster St
Tupelo, MS 38801
Phone (662) 377-3136

150 Medical Center Dr
West Point, MS 39773
Phone (601) 494-2321

Interoperability endpoints

  • Direct secure messaging: benlong@magnolia.medalliesdirect.net

Organizations & group practices 9

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1465257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624924800000",
    "number": "1255780680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1144 PEACHTREE ST",
            "city": "CORINTH",
            "state": "MS",
            "postal_code": "388342327",
            "telephone_number": "662-284-5056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 ALCORN DR",
            "city": "CORINTH",
            "state": "MS",
            "postal_code": "388349388",
            "telephone_number": "662-293-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "96 Jonathan Lucas St",
            "address_2": "Suite 803 MSC 623",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "SC",
            "postal_code": "294258900",
            "country_code": "US",
            "telephone_number": "843-792-2911",
            "fax_number": "843-792-5265",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LONG",
        "first_name": "BEN",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-06-07",
        "last_updated": "2021-06-29",
        "certification_date": "2021-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": "LL39688",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "blong@magnolia.medallies.direct.net",
            "affiliation": "N",
            "endpointDescription": "Direct Message Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "611 Alcorn Dr",
            "city": "Corinth",
            "state": "MS",
            "country_code": "US",
            "postal_code": "388349388",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Corinth, MS

Sources for this page

Verify at the official NPI Registry.