Stephanie C Long, M.D.
Individual provider Active NPI Family Medicine Physician · Warrensburg, MO
NPI 1477594927 · NPPES record last updated Nov 9, 2016
Key facts
- NPI
- 1477594927
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 104166 (MO)
- Practice address
- 513 Burkarth Rd
Warrensburg, MO 64093-3103 - Phone
- (660) 747-7751
- NPI assigned
- Jun 8, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- University of Missouri, Kansas City, School of Medicine, 1990
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Western Missouri Medical Center
Practice addresses (Care Compare)
403 Burkarth Rd
Warrensburg, MO 64093-3101
513 Burkarth Rd
Warrensburg, MO 64093-3103
Phone (660) 747-7751
Hospital & facility affiliations
- Western Missouri Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100317001070 | MO | Practitioner - Family Practice | 7618002452 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Western Missouri Medical Center | Family Medicine | Current |
Accepting new patients |
Locations
1200 W 22nd St
Higginsville, MO 64037
Phone (660) 262-7751
513 Burkarth Rd
Warrensburg, MO 64093
Phone (660) 747-7751
403 Burkarth Rd
Warrensburg, MO 64093
Phone (660) 474-2500
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 104166 | MO | Yes |
Addresses
Primary practice location
513 Burkarth Rd
Warrensburg, MO 64093-3103
Mailing address
513 Burkarth Rd
Warrensburg, MO 64093-3103
Phone (660) 747-7751
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 206687006 | Medicaid | MO | |
| 19595012 | Other | MO | BCBS |
Other providers in Warrensburg, MO
- Amanda Littrell
- Ben Chin Liu
- Anika Lashun Livingston-Browdy
- Zachary D Loeffelholz
- Evan Scott Logue
- Alexis Looney
- Jessica Lopez
- Jessica Love
- Victor Manuel Lovell
- Alexa Jean Luking
All providers in Warrensburg, MO · Family Medicine Physician in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 9, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.