Active NPI
Richard L. Long, D.O.
- Family Medicine Physician
- Mandeville, LA
National Provider Identifier
1407891443
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 000041
- Practice address
- 201 St. Ann Drive
Suite B
Mandeville, LA 70471 - Phone
- (985) 626-1717
- Fax
- (985) 674-2814
- NPI assigned
- Jun 16, 2006
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 10861 | MS | |
| Family Medicine Physician | 207Q00000X | 000041 | LA | Primary |
Addresses
Primary practice location
201 St. Ann Drive
Suite B
Mandeville, LA 70471
Mailing address
201 St. Ann Drive
Suite B
Mandeville, LA 70471
Phone (985) 626-1717
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1459992 | Medicaid | LA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in LA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- West Virginia School of Osteopathic Medicine, 1984
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
1202 S Tyler St
Covington, LA 70433-2330
Phone (985) 898-3743
201 Saint Ann Dr B
Mandeville, LA 70471-3219
Phone (985) 626-1717
Hospital & facility affiliations
- St. Tammany Hospital Home Health
- St Tammany Parish Hospital
- Ochsner Medical Center Acute
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy, Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 000041 | LA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St. Tammany Parish Hospital Service District No 1 | Current | Accepting new patients | |
| Heartsouth PLLC | Family Medicine | Past | Accepting new patients |
| Forrest County General Hospital | Past | Accepting new patients |
Locations
80 Gardenia Dr
Ste B
Covington, LA 70433
Phone (985) 871-5900
1202 S Tyler St
Covington, LA 70433
Phone (985) 898-3743
1520 Highway 22 W
Madisonville, LA 70447
Phone (985) 773-1600
201 Saint Ann Dr
Ste B
Mandeville, LA 70471
Phone (985) 626-1717
Interoperability endpoints
- https://api.platform.athenahealth.com/2667/brand/1/csg/1/fhir/r4
Organizations & group practices 4
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.
-
- General Acute Care Hospital
- Covington, LA
- NPI 1598798597
-
- Internal Medicine Physician
- Covington, LA
- NPI 1083793582
-
- Critical Access Hospital
- Poplarville, MS
- NPI 1003026717
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- New Orleans, LA
- NPI 1811973100
-
- Internal Medicine Physician
- Covington, LA
- NPI 1083793582
Hospital
-
- Pulmonary Disease Physician
- Covington, LA
- NPI 1285285874
Hospital
-
- Home Health Agency
- Madisonville, LA
- NPI 1568483550
-
- General Acute Care Hospital
- Covington, LA
- NPI 1598798597
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150416000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1343692800000",
"number": "1407891443",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "201 ST. ANN DRIVE",
"address_2": "SUITE B",
"city": "MANDEVILLE",
"state": "LA",
"postal_code": "70471",
"telephone_number": "985-626-1717",
"fax_number": "985-674-2814"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "201 ST. ANN DRIVE",
"address_2": "SUITE B",
"city": "MANDEVILLE",
"state": "LA",
"postal_code": "70471",
"telephone_number": "985-626-1717",
"fax_number": "985-674-2814"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LONG",
"first_name": "RICHARD",
"middle_name": "L.",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-16",
"last_updated": "2012-07-31",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MS",
"license": "10861",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "LA",
"license": "000041",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1459992",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Mandeville, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2012; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.