Individual provider Active NPI

David Antonio Long Jr., M.D.

  • Anesthesiology Physician
  • Atlanta, GA
National Provider Identifier
1598028508
Registry record updated Nov 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
90070 Issued in GA
Practice address
1968 Peachtree Rd NW
Atlanta, GA 30309-1281
Phone
(678) 216-0771
NPI assigned
Jun 25, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 262131 MA
Student in an Organized Health Care Education/Training Program 390200000X TRN17815 FL
Anesthesiology Physician 207L00000X 90070 GA Primary

Addresses

Primary practice location

1968 Peachtree Rd NW
Atlanta, GA 30309-1281

Mailing address

950 Brickell Bay Dr
Apt 1804
Miami, FL 33131-3931

Other practice location 1

775 Poplar Rd Ste Ll20
Newnan, GA 30265-8306
Phone (770) 253-1912

Other practice location 2

1265 Highway 54 W Ste 103
Fayetteville, GA 30214-4537
Phone (678) 216-0771

Other practice location 3

745 Poplar Rd
Newnan, GA 30265-1618
Phone (770) 400-1000

Other practice location 4

1255 Highway 54 W
Fayetteville, GA 30214-4526
Phone (404) 351-1745

Other practice location 5

1800 Howell Mill Rd NW Ste 250
Atlanta, GA 30318-2593
Phone (404) 537-4910

Other practice location 6

3400 E Racine St
Janesville, WI 53546-2344
Phone (608) 373-8000

Other practice location 7

1611 NW 12th Ave
Miami, FL 33136-1005
Phone (305) 585-6973

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address dlong387222@direct-ehr-ssmhc.com Direct
FHIR URL https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ Other

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, GA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20170810001321 IL Practitioner - Anesthesiology 0547576159 Reassigns benefits to 1 organization
I20211124000904 GA Practitioner - Anesthesiology 0547576159 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Piedmont Anesthesia LLCGroup PAC ID 2163837972, 555 clinicians

Practice addresses (Care Compare)

1133 Eagles Landing Pkwy
Stockbridge, GA 30281-5085
Phone (800) 242-1131

1968 Peachtree Rd NW
Atlanta, GA 30309-1281
Phone (404) 351-1745

Hospital & facility affiliations

  • Piedmont Hospital, Inc Hospital, Atlanta, GA, CCN 110083
  • Piedmont Fayette Hospital Hospital, Fayetteville, GA, CCN 110215

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
TRN17815FLMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Northstar Anesthesia of Illinois, LLC Anesthesiology CurrentSince Aug 14, 2017 Accepting new patients
Piedmont Anesthesia Associates, L.L.C Anesthesiology CurrentSince Oct 12, 2021 Accepting new patients
Piedmont Anesthesia LLC Anesthesiology CurrentSince May 1, 2025 Accepting new patients

Locations

1968 Ptree Rd NW
Atlanta, GA 30309
Phone (404) 605-2222

1800 Howell Mill Rd NW
Ste 250
Atlanta, GA 30318
Phone (404) 537-4910

1984 Peachtree Rd NW
Ste 515
Atlanta, GA 30309
Phone (404) 351-1754

1265 Highway 54 W
Ste 103
Fayetteville, GA 30214
Phone (678) 216-0771

1255 Highway 54 W
Fayetteville, GA 30214
Phone (770) 719-6911

775 Poplar Rd
Ste LL20
Newnan, GA 30265
Phone (770) 253-1912

745 Poplar Rd
Newnan, GA 30265
Phone (404) 478-8785

1133 Eagles Landing Pkwy
Stockbridge, GA 30281
Phone (678) 604-1000

20201 Crawford Ave
Olympia Flds, IL 60461
Phone (708) 503-3857

1423 Chicago Rd
Sauk Village, IL 60411
Phone (708) 679-2160

Organizations & group practices 3

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 2

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": "1340582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669161600000",
    "number": "1598028508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 BRICKELL BAY DR",
            "address_2": "APT 1804",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331313931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1968 PEACHTREE RD NW",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303091281",
            "telephone_number": "678-216-0771"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "775 Poplar Rd Ste Ll20",
            "address_purpose": "LOCATION",
            "city": "Newnan",
            "state": "GA",
            "postal_code": "302658306",
            "country_code": "US",
            "telephone_number": "770-253-1912",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1265 Highway 54 W Ste 103",
            "address_purpose": "LOCATION",
            "city": "Fayetteville",
            "state": "GA",
            "postal_code": "302144537",
            "country_code": "US",
            "telephone_number": "678-216-0771",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "745 Poplar Rd",
            "address_purpose": "LOCATION",
            "city": "Newnan",
            "state": "GA",
            "postal_code": "302651618",
            "country_code": "US",
            "telephone_number": "770-400-1000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1255 Highway 54 W",
            "address_purpose": "LOCATION",
            "city": "Fayetteville",
            "state": "GA",
            "postal_code": "302144526",
            "country_code": "US",
            "telephone_number": "404-351-1745",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1800 Howell Mill Rd NW Ste 250",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303182593",
            "country_code": "US",
            "telephone_number": "404-537-4910",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3400 E Racine St",
            "address_purpose": "LOCATION",
            "city": "Janesville",
            "state": "WI",
            "postal_code": "535462344",
            "country_code": "US",
            "telephone_number": "608-373-8000",
            "fax_number": "608-373-8795",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1611 NW 12th Ave",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331361005",
            "country_code": "US",
            "telephone_number": "305-585-6973",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LONG",
        "first_name": "DAVID",
        "middle_name": "ANTONIO",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-25",
        "last_updated": "2022-11-23",
        "certification_date": "2022-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MA",
            "license": "262131",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "FL",
            "license": "TRN17815",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "GA",
            "license": "90070",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dlong387222@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "dlong387222@direct-ehr-ssmhc.com",
            "address_1": "3400 E Racine St",
            "city": "Janesville",
            "state": "WI",
            "country_code": "US",
            "postal_code": "535462344",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "3400 E Racine St",
            "city": "Janesville",
            "state": "WI",
            "country_code": "US",
            "postal_code": "535462344",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.