Active NPI
Shawn E Long, M.D.
- Family Medicine Physician
- Oakland, MD
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- D0078630
- Practice address
- 1027 Memorial Dr
Oakland, MD 21550-4343 - Phone
- (301) 533-3300
- Fax
- (301) 533-3299
- NPI assigned
- Sep 16, 2006
- Last updated
- Apr 1, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 20683 | WV | |
| Family Medicine Physician | 207Q00000X | D0078630 | MD | Primary |
Addresses
Primary practice location
1027 Memorial Dr
Oakland, MD 21550-4343
Mailing address
1027 Memorial Dr
Oakland, MD 21550-4343
Phone (301) 533-3300
Other practice location 1
22221 Westernport Rd SW
Westernport, MD 21562-2206
Phone (240) 774-0204
Other practice location 2
104 Parkview Dr
Grantsville, MD 21536-1086
Phone (844) 652-8730
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 402362500 | Medicaid | MD | |
| 2005302000 | Medicaid | WV |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA, NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D0078630 | MD | MD | Family Medicine Physician |
| 20683 | WV | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wellbe Senior Medical Group of Pennsylvania PC | Current | Accepting new patients | |
| Russo & Long Enterpirses Inc | Current | Accepting new patients | |
| Wellbe New York Medical PC | Current | Accepting new patients | |
| Frederick Health Hospital Inc | Past | Accepting new patients | |
| Western Maryland Health Care Corporation | Past | Accepting new patients | |
| West Virginia University Hospitals, Inc | Past | Accepting new patients |
Locations
225 W Washington St
Ste 1500
Chicago, IL 60606
Phone (312) 776-2422
225 W Washington St
Ste 1700
Chicago, IL 60606
Phone (234) 200-4220
1156 6th Ave
New York, NY 10036
Phone (312) 776-2410
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Internal Medicine Physician
- Rochester, NY
- NPI 1902586712
-
- Internal Medicine Physician
- Pittsburgh, PA
- NPI 1255089132
-
dba AmeriCARE Pittsburgh
- In Home Supportive Care Agency
- Canonsburg, PA
- NPI 1568148484
-
dba Frederick Health Hospital
- General Acute Care Hospital
- Frederick, MD
- NPI 1538165527
-
dba WVUH Professional Group
- Emergency Medicine Physician
- Morgantown, WV
- NPI 1740763952
-
dba Mountain Laurel Medical Center
- Federally Qualified Health Center (FQHC)
- Bruceton Mills, WV
- NPI 1679269807
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158364800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1585699200000",
"number": "1639275332",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1027 MEMORIAL DR",
"city": "OAKLAND",
"state": "MD",
"postal_code": "215504343",
"telephone_number": "301-533-3300",
"fax_number": "301-533-3299"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1027 MEMORIAL DR",
"city": "OAKLAND",
"state": "MD",
"postal_code": "215504343",
"telephone_number": "301-533-3300",
"fax_number": "301-533-3299"
}
],
"practiceLocations": [
{
"address_1": "22221 Westernport Rd SW",
"address_purpose": "LOCATION",
"city": "Westernport",
"state": "MD",
"postal_code": "215622206",
"country_code": "US",
"telephone_number": "240-774-0204",
"fax_number": "301-533-3299",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "104 Parkview Dr",
"address_purpose": "LOCATION",
"city": "Grantsville",
"state": "MD",
"postal_code": "215361086",
"country_code": "US",
"telephone_number": "844-652-8730",
"fax_number": "301-533-3299",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LONG",
"first_name": "SHAWN",
"middle_name": "E",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-16",
"last_updated": "2020-04-01",
"certification_date": "2020-04-01",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "WV",
"license": "20683",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MD",
"license": "D0078630",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "402362500",
"state": "MD"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2005302000",
"state": "WV"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Oakland, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.