NPIMap

Individual provider Active NPI

Summer Dawn Long, PAC

  • Cardiovascular Disease Physician
  • Grand Junction, CO
National Provider Identifier
1518903574
Registry record updated Jan 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
2182 Issued in CO
Practice address
743 Horizon Court
Ste 105
Grand Junction, CO 81506
Phone
(970) 244-8708
NPI assigned
Jun 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 2182 CO Primary

Addresses

Primary practice location

743 Horizon Court
Ste 105
Grand Junction, CO 81506

Mailing address

425 Patterson Rd
Ste 605
Grand Junction, CO 81506
Phone (970) 244-2482

Other identifiers 1

IdentifierTypeStateIssuer
86334051MedicaidCO

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060406000343 CO Practitioner - Physician Assistant 9931118783 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1050 Wellington Ave
Imh Wellington Lung and Sleep Clinic
Grand Junction, CO 81501-8121
Phone (970) 298-5864

2440 N 11St St
Western Colorado Obesity Management Clinic
Grand Junction, CO 81501-8102
Phone (970) 298-6400

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
2182COMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Mary'S Hospital and Medical Center, Inc CurrentSince Dec 15, 2012 Accepting new patients
Intermountain Medical Group Grand Junction, LLC CurrentSince Oct 4, 2014 Accepting new patients
Intermountain Medical Group Grand Junction, LLC Cardiovascular Disease CurrentSince Oct 4, 2014 Accepting new patients
St Mary'S Hospital and Medical Center, Inc Past Accepting new patients
Western Slope Cardiology, PC Cardiovascular Disease Past Accepting new patients

Locations

2440 N 11th St
Grand Junction, CO 81501
Phone (970) 243-0900

1050 Wellington Ave
Slp Ctr
Grand Junction, CO 81501
Phone (970) 298-5864

2643 Patterson Rd
Ste 605
Grand Junction, CO 81506
Phone (970) 244-2482

2635 N 7th St
Grand Junction, CO 81501
Phone (970) 244-2009

1050 Wellington Ave
Grand Junction, CO 81501
Phone (970) 245-4810

Organizations & group practices 6

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.

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1150761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1263427200000",
    "number": "1518903574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 PATTERSON RD",
            "address_2": "STE 605",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "81506",
            "telephone_number": "970-244-2482",
            "fax_number": "970-255-1701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "743 HORIZON COURT",
            "address_2": "STE 105",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "81506",
            "telephone_number": "970-244-8708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONG",
        "first_name": "SUMMER",
        "middle_name": "DAWN",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-20",
        "last_updated": "2010-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CO",
            "license": "2182",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "86334051",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Junction, CO

Sources for this page

Verify at the official NPI Registry.