NPIMap

Individual provider Active NPI

Christina S Long, DPM

  • Foot & Ankle Surgery Podiatrist
  • Winston Salem, NC
National Provider Identifier
1518107747
Registry record updated Jun 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
571 Issued in NC
Practice address
131 Miller St
Winston Salem, NC 27103-2508
Phone
(336) 716-0572
Fax
(336) 716-8018
NPI assigned
Feb 27, 2009
Last updated
Jun 12, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 571 NC Primary

Addresses

Primary practice location

131 Miller St
Winston Salem, NC 27103-2508

Mailing address

Wake Forest Baptist Health
Medical Center Blvd
Winston Salem, NC 27157-0001
Phone (336) 716-0572

Other identifiers 1

IdentifierTypeStateIssuer
5917629MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, ME2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20110823000499 NC Practitioner - Podiatry 4789854134
I20200803003331 ME Practitioner - Podiatry 4789854134 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Portland Foot and Ankle, PAGroup PAC ID 2264409366, 5 clinicians

Practice addresses (Care Compare)

63 Marginal Way
Suite 300
Portland, ME 04101-1964
Phone (207) 879-1339

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.93 of 100Reported as apm
Quality
83.31
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of tissue44
Removal of skin lesions49
Removal of nail tissue245
Removal or shaving of skin growth65

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
571NCMDHearing Instrument Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Portland Foot & Ankle, PA Foot & Ankle Surgery CurrentSince Jul 13, 2020 Accepting new patients

Locations

63 Marginal Way
Ste 300
Portland, ME 04101
Phone (207) 879-1339

68 Marginal Way
#4
Portland, ME 04101

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 36

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 36

NPI Registry JSON

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

{
    "created_epoch": "1235692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370995200000",
    "number": "1518107747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "WAKE FOREST BAPTIST HEALTH",
            "address_2": "MEDICAL CENTER BLVD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271570001",
            "telephone_number": "336-716-0572",
            "fax_number": "336-716-8018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 MILLER ST",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271032508",
            "telephone_number": "336-716-0572",
            "fax_number": "336-716-8018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONG",
        "first_name": "CHRISTINA",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-02-27",
        "last_updated": "2013-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NC",
            "license": "571",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5917629",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

Verify at the official NPI Registry.