Active NPI
Randall R Long, M.D.PHD
- Neurology Physician
- Keene, NH
National Provider Identifier
1265416119
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology Physician
- License
- 45880
- Practice address
- 590 Court St
Keene, NH 03431-1719 - Phone
- (603) 354-5454
- NPI assigned
- Dec 5, 2005
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Neurology Physician | 2084N0400X | 45880 | MA | Primary |
Addresses
Primary practice location
590 Court St
Keene, NH 03431-1719
Mailing address
590 Court St
Keene, NH 03431-1719
Phone (603) 354-5454
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0109185 | Medicaid | MA | |
| 30208176 | Medicaid | NH |
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
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 45880 | MA | MD | Neurology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Umass Memorial Medical Group Inc | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Internal Medicine Physician
- Worcester, MA
- NPI 1760445373
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1133740800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1338768000000",
"number": "1265416119",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "590 COURT ST",
"city": "KEENE",
"state": "NH",
"postal_code": "034311719",
"telephone_number": "603-354-5454"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "590 COURT ST",
"city": "KEENE",
"state": "NH",
"postal_code": "034311719",
"telephone_number": "603-354-5454"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LONG",
"first_name": "RANDALL",
"middle_name": "R",
"credential": "M.D.PHD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-12-05",
"last_updated": "2012-06-04",
"status": "A"
},
"taxonomies": [
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "MA",
"license": "45880",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0109185",
"state": "MA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "30208176",
"state": "NH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Keene, NH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 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.