Longevity Institute of Indiana,P.C.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

01021582A Issued in IN

Legal business name

LONGEVITY INSTITUTE OF INDIANA,P.C.

Practice address

10291 N Meridian St
Suite 300
Indianapolis, IN 46290-1076

Phone

(317) 574-1677

Fax

(317) 574-1688

NPI assigned

Oct 10, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Arthur J Sumrall, M.D., M.A.

Title

Owner

Phone

(317) 574-1677

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1191974400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1404345600000",
    "number": "1487842860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10291 N MERIDIAN ST",
            "address_2": "SUITE 300",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462901076",
            "telephone_number": "317-574-1677",
            "fax_number": "317-574-1688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10291 N MERIDIAN ST",
            "address_2": "SUITE 300",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462901076",
            "telephone_number": "317-574-1677",
            "fax_number": "317-574-1688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LONGEVITY INSTITUTE OF INDIANA,P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-10",
        "last_updated": "2014-07-03",
        "status": "A",
        "authorized_official_last_name": "SUMRALL",
        "authorized_official_first_name": "ARTHUR",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "317-574-1677",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D., M.A."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "IN",
            "license": "01021582A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000087198",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• William Randall Long, D.D.S.
• Sarah J Longe, LCSW
• Jennifer Longenecker
• Diane Marie Longerbone, MA.,RD.,CD.
• Longevity Clinical LTC Associates of Indiana, PC
• Jill Marie Longfellow, DPT
• Sarah J Longmire-Cook, MD
• Scott M Longmuir, PT, DPT, OCS, CSCS
• Sheila Marie Longpre, PTA
• William Longstreet

• Dermatology Physician in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Dermatology Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.