Individual provider Active NPI

Steven Michael Longo, DC

  • Chiropractor
  • Greenfield, WI
National Provider Identifier
1447244850
Registry record updated Nov 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2553012 Issued in WI
Practice address
8405 W Forest Home Ave
Ste 101
Greenfield, WI 53228-3407
Phone
(414) 421-2225
Fax
(414) 421-7576
NPI assigned
Aug 31, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2553012 WI Primary

Addresses

Primary practice location

8405 W Forest Home Ave
Ste 101
Greenfield, WI 53228-3407

Mailing address

8405 W Forest Home Ave
Ste 101
Greenfield, WI 53228-3407
Phone (414) 421-2225

Other identifiers 1

IdentifierTypeStateIssuer
38849900MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040124000259 WI Practitioner - Chiropractic 1355243775 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

8405 W Forest Home Ave
Suite 101
Greenfield, WI 53228-3407
Phone (414) 421-2225

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2553012WIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Longo Chiropractic, S.C. Chiropractor CurrentSince Jul 14, 1990 Accepting new patients
Scott J. Wagenknecht, LLC Chiropractor CurrentSince Jun 1, 2000 Accepting new patients

Locations

8405 W Forest Home Ave
Greenfield, WI 53228
Phone (414) 425-7710

8405 W Forest Home Ave
Ste 101
Milwaukee, WI 53228
Phone (414) 421-2225

Organizations & group practices 2

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": "1125446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353888000000",
    "number": "1447244850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8405 W FOREST HOME AVE",
            "address_2": "STE 101",
            "city": "GREENFIELD",
            "state": "WI",
            "postal_code": "532283407",
            "telephone_number": "414-421-2225",
            "fax_number": "414-421-7576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8405 W FOREST HOME AVE",
            "address_2": "STE 101",
            "city": "GREENFIELD",
            "state": "WI",
            "postal_code": "532283407",
            "telephone_number": "414-421-2225",
            "fax_number": "414-421-7576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONGO",
        "first_name": "STEVEN",
        "middle_name": "MICHAEL",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-31",
        "last_updated": "2012-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "2553012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38849900",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenfield, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.