Fallon Longmire, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

ME160275 Issued in FL

Practice address

901 22ND Ave S
St Petersburg, FL 33705-2933

Phone

(727) 310-0925

Fax

(727) 498-5470

NPI assigned

Apr 14, 2019

Last updated

Jun 20, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• Optimum HealthCare HMO Network
• Freedom Health HMO Network

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Dedicated Senior Medical Center of Florida, LLC

  • Specialist
  • Miami Gardens, FL
  • NPI 1881055366
  Medicare reassignment NPD
• Dedicated Senior Medical Center of Florida, LLC

  • Specialist
  • Largo, FL
  • NPI 1659888741
  NPD
• Dedicated Senior Medical Center of Florida, LLC

  • Specialist
  • Tampa, FL
  • NPI 1700393881
  NPD

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

{
    "created_epoch": "1555200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687219200000",
    "number": "1306409545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 22ND AVE S",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337052933",
            "telephone_number": "727-310-0925",
            "fax_number": "727-498-5470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 22ND AVE S",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337052933",
            "telephone_number": "727-310-0925",
            "fax_number": "727-498-5470"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "206 2nd St E",
            "address_purpose": "LOCATION",
            "city": "Bradenton",
            "state": "FL",
            "postal_code": "342081042",
            "country_code": "US",
            "telephone_number": "941-746-5111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LONGMIRE",
        "first_name": "FALLON",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-14",
        "last_updated": "2023-06-20",
        "certification_date": "2023-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME160275",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matt Long
• Molly M Long, MD
• Jeffrey Robert Longfellow, DC
• Julie V. Longfellow, MD
• Longleaf Alf LLC
• Jennifer Ann Longo, M.D.
• Janet A Loo, ARNP
• Britni Hill Looper, M.D.
• Celia Maria Lopez-McCormack, M.D.
• Chelsi Lopez

• Internal Medicine Physician in St Petersburg, FL
• Providers in St Petersburg, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.