Individual provider Active NPI

Sok Thy Bryant Long II, MD

  • Internal Medicine Physician
  • Flint, MI
National Provider Identifier
1437610680
Registry record updated Jan 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
333785 Issued in LA
Practice address
401 S Ballenger Hwy
Flint, MI 48532-3638
Phone
(810) 342-2000
Fax
(810) 342-3659
NPI assigned
Mar 29, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 57247659 OH
Student in an Organized Health Care Education/Training Program 390200000X 57.247659 OH
Student in an Organized Health Care Education/Training Program 390200000X 4351049651 MI
Internal Medicine Physician 207R00000X 333785 LA Primary

Addresses

Primary practice location

401 S Ballenger Hwy
Flint, MI 48532-3638

Mailing address

401 S Ballenger Hwy
Flint, MI 48532-3638
Phone (810) 342-2000

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230216003030 LA Practitioner - Internal Medicine 2466782933 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
333785LAMDInternal Medicine Physician
57247659OHMDInternal Medicine Physician

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.

NPI Registry JSON

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

{
    "created_epoch": "1553817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705968000000",
    "number": "1437610680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 S BALLENGER HWY",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485323638",
            "telephone_number": "810-342-2000",
            "fax_number": "810-342-3659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 S BALLENGER HWY",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485323638",
            "telephone_number": "810-342-2000",
            "fax_number": "810-342-3659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONG",
        "first_name": "SOK THY",
        "middle_name": "BRYANT",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-29",
        "last_updated": "2024-01-23",
        "certification_date": "2024-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "57247659",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "OH",
            "license": "57.247659",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": "4351049651",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "LA",
            "license": "333785",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flint, MI

Sources for this page

Verify at the official NPI Registry.