Gordon David Long, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

35-04-9038L Issued in OH

Practice address

715 Richland Mall
Ontario, OH 44906-3802

Phone

(419) 529-6195

NPI assigned

Aug 20, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OH

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: glong490010@direct.osumc.edu

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.

• Galion Community Hospital

  • Critical Access Hospital
  • Galion, OH
  • NPI 1215907522

  Family Medicine

  Medicare reassignment NPD
• Galion Community Hospital

  • Pharmacy
  • Crestline, OH
  • NPI 1346061256
  NPD
• Shelby Family Medicine Inc

  • Family Medicine Physician
  • Shelby, OH
  • NPI 1255526125
  NPD (past)

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

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656979200000",
    "number": "1487769766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 N COLUMBUS ST",
            "city": "CRESTLINE",
            "state": "OH",
            "postal_code": "448271455",
            "telephone_number": "419-529-6195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 RICHLAND MALL",
            "city": "ONTARIO",
            "state": "OH",
            "postal_code": "449063802",
            "telephone_number": "419-529-6195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONG",
        "first_name": "GORDON",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-20",
        "last_updated": "2022-07-05",
        "certification_date": "2022-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35-04-9038L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0537762",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "glong490010@direct.osumc.edu",
            "affiliation": "N",
            "address_1": "715 Richland Mall",
            "city": "Ontario",
            "state": "OH",
            "country_code": "US",
            "postal_code": "449063802",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Irene I Lin, DDS
• Lincare Inc
• Charles(Chiaho) Liu, DMD
• Mary Lofreso
• Chelsi Renee Lohr
• Jodi L Ludwick, RPH
• Luxottica of America Inc
• Brenda Mabe
• Ashley Mack
• John Thomas Mallett, PHARM.D.

• Family Medicine Physician in Ontario, OH
• Providers in Ontario, OH by specialty
• Family Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.