NPIMap

Individual provider Active NPI

David Lynn Long, MD

  • Anesthesiology Physician
  • Columbia, SC
National Provider Identifier
1609956770
Registry record updated Feb 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
14626 Issued in SC
Practice address
1330 Taylor St
Columbia, SC 29201-2915
Phone
(803) 708-8126
Fax
(803) 708-1370
NPI assigned
Oct 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Anesthesiology) Physician 207LC0200X 14626 SC
Pain Medicine (Anesthesiology) Physician 207LP2900X 14626 SC
Anesthesiology Physician 207L00000X 14626 SC Primary

Addresses

Primary practice location

1330 Taylor St
Columbia, SC 29201-2915

Mailing address

300 E McBee Ave FL 4
Greenville, SC 29601-2842
Phone (864) 522-8614

Other identifiers 6

IdentifierTypeStateIssuer
050028875OtherSCRR MEDICARE
146265MedicaidSC
4229859OtherSCAETNA
146265OtherSCSELECT HEALTH
2001249OtherSCCCP
77842OtherSCMEDCOST

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20110126001002 SC Practitioner - Anesthesiology 9133308885 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
West Virginia University School of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prisma Health University Medical GroupGroup PAC ID 8325950983, 2,467 clinicians

Practice addresses (Care Compare)

1330 Taylor St
Columbia, SC 29201-2915
Phone (803) 296-5137

Hospital & facility affiliations

  • Prisma Health Baptist Hospital, Columbia, SC, CCN 420086
  • Prisma Health Baptist Parkridge Hospital, Columbia, SC, CCN 420106
  • Prisma Health Richland Hospital Hospital, Columbia, SC, CCN 420018

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
14626SCMDPain Medicine (Anesthesiology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health University Medical Group Anesthesiology CurrentSince Dec 1, 2020 Accepting new patients
Prisma Health University Medical Group CurrentSince Dec 1, 2020 Accepting new patients
Prisma Health University Medical Group Current Accepting new patients
Cardiovascular Ansthesia, LLC Anesthesiology Past Accepting new patients
Pain Management, LLC Past Accepting new patients

Locations

1330 Taylor St
Columbia, SC 29201
Phone (803) 296-5137

67 Creekside Park Ct
Greenville, SC 29615
Phone (864) 242-4602

300 E McBee Ave
Fl 4
Greenville, SC 29601
Phone (864) 522-8615

Organizations & group practices 5

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 10

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": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612742400000",
    "number": "1609956770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E MCBEE AVE FL 4",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296012842",
            "telephone_number": "864-522-8614",
            "fax_number": "240-566-1600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 TAYLOR ST",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292012915",
            "telephone_number": "803-708-8126",
            "fax_number": "803-708-1370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONG",
        "first_name": "DAVID",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-16",
        "last_updated": "2021-02-08",
        "certification_date": "2021-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LC0200X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Critical Care Medicine",
            "state": "SC",
            "license": "14626",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "SC",
            "license": "14626",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "SC",
            "license": "14626",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "050028875",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "146265",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4229859",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SELECT HEALTH",
            "identifier": "146265",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CCP",
            "identifier": "2001249",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST",
            "identifier": "77842",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.