Active NPI
Dail Wilson Longaker, MD
- Surgery Physician
- Columbia, SC
National Provider Identifier
1356537500
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 4865
- Practice address
- 4614 Perry CT
Columbia, SC 29206-4516 - Phone
- (803) 782-4549
- NPI assigned
- Sep 21, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 4865 | SC | Primary |
Addresses
Primary practice location
4614 Perry CT
Columbia, SC 29206-4516
Mailing address
4614 Perry CT
Columbia, SC 29206-4516
Phone (803) 782-4549
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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4865 | SC | MD | Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1190332800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1190332800000",
"number": "1356537500",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4614 PERRY CT",
"city": "COLUMBIA",
"state": "SC",
"postal_code": "292064516",
"telephone_number": "803-782-4549"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4614 PERRY CT",
"city": "COLUMBIA",
"state": "SC",
"postal_code": "292064516",
"telephone_number": "803-782-4549"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LONGAKER",
"first_name": "DAIL",
"middle_name": "WILSON",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-09-21",
"last_updated": "2007-09-21",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "SC",
"license": "4865",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Columbia, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.