Thad D Long, MD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

020769 Issued in GA

Practice address

1601 Fair Rd
Suite 1100
Statesboro, GA 30458-1698

Phone

(678) 469-0007

Fax

(321) 206-0834

NPI assigned

Aug 11, 2005

Last updated

Aug 20, 2012By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Commerce Radiology, LLC

  • Diagnostic Ultrasound Physician
  • Commerce, GA
  • NPI 1821341272
  NPD (past) Authorized official
• Diagnostic Radiology Services

  • Specialist
  • Marietta, GA
  • NPI 1881861987
  NPD (past)
• East Georgia Regional Medical Center, LLC

  • General Acute Care Hospital
  • Statesboro, GA
  • NPI 1265486278
  NPD (past)
• Medical Diagnostics of Statesboro LLC

  • Radiology Clinic/Center
  • Statesboro, GA
  • NPI 1144271107
  NPD (past)
• Optimal Readings Professional Services, LLC

  • Diagnostic Radiology Physician
  • Waycross, GA
  • NPI 1912052192
  NPD (past)

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

{
    "created_epoch": "1123718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1345420800000",
    "number": "1427050368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 FAIR RD",
            "address_2": "SUITE 1100",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304581698",
            "telephone_number": "678-469-0007",
            "fax_number": "321-206-0834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 FAIR RD",
            "address_2": "SUITE 1100",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304581698",
            "telephone_number": "678-469-0007",
            "fax_number": "321-206-0834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONG",
        "first_name": "THAD",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-11",
        "last_updated": "2012-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "GA",
            "license": "020769",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00237157H",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lisa S Robinson, DO PC
• Delores Deanne Liston, LCSW
• Taunia K Locker, MS, LPC
• Keisha Bernice Lockhart
• Jamia Lofton
• Allyson Paige Looby, ATC
• Wendy Lopez
• Latoya Lorick
• Louden Fairfax Care LLC
• Banee Joyce Louis

• Diagnostic Radiology Physician in Statesboro, GA
• Providers in Statesboro, GA by specialty
• Diagnostic Radiology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 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.

Verify at the official NPI Registry.