Derek S Long OD Inc

Primary specialty

OptometristTaxonomy code 152W00000X

License

2547 Issued in AR

Legal business name

DEREK S LONG OD INC

Practice address

4425 Central Ave Ste B
Hot Springs, AR 71913-7297

Phone

(501) 525-0501

Fax

(501) 525-0628

NPI assigned

May 28, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Derek S Long, ODNPI 1699734368

Title

Doctor

Phone

(501) 803-3937

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Eye Exams, Inc Doing business as

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Derek S Long OD Inc

  • Optometrist
  • North Little Rock, AR
  • NPI 1255577532

  O20090511000536

  Same enrollment
• Derek S Long OD, Inc

  • Optometrist
  • Maumelle, AR
  • NPI 1043412067

  O20090511000536

  Same enrollment

Tax ID family

Derek S Long OD Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Derek S Long OD, Inc

  • Optometrist
  • Maumelle, AR
  • NPI 1043412067
  NPD tax ID
• Little Rock Air Force Base Eye Care

  • Optometrist
  • Little Rock, AR
  • NPI 1356876577
  NPD tax ID

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Derek Scott Long, O.D.

  • Optometrist
  • Maumelle, AR
  • NPI 1699734368
  NPD Authorized official
• Edward Lee McDonnell, O.D.

  • Optometrist
  • Magnolia, AR
  • NPI 1770542508
  NPD
• Andrea Walker

  • Optometrist
  • Maumelle, AR
  • NPI 1780067587
  NPD

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

{
    "created_epoch": "1211932800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1274659200000",
    "number": "1487812392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 AUDUBON DR STE 8",
            "city": "MAUMELLE",
            "state": "AR",
            "postal_code": "721137409",
            "telephone_number": "501-803-3937",
            "fax_number": "501-803-3962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4425 CENTRAL AVE STE B",
            "city": "HOT SPRINGS",
            "state": "AR",
            "postal_code": "719137297",
            "telephone_number": "501-525-0501",
            "fax_number": "501-525-0628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEREK S LONG OD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-28",
        "last_updated": "2010-05-24",
        "status": "A",
        "authorized_official_last_name": "LONG",
        "authorized_official_first_name": "DEREK",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "501-803-3937",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "AR",
            "license": "2547",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "180260722",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eye Exams, Inc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Deborah D Dennie, LPC
• Beverly Dennis
• Gabrielle Dennis
• Kara Dennis
• Joyce Ann Denton, PT
• Sawyer Rae Derrick
• Aditi Hemantkumar Desai, DDS
• David Desoto, M.D.
• Roshan Dhakal
• Diamond Flight Medical, LLC

• Optometrist in Hot Springs, AR
• Providers in Hot Springs, AR by specialty
• Optometrist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.