Active NPI
Billy W Long, MD
- Gastroenterology Physician
- Jackson, MS
National Provider Identifier
1649268822
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- 06744
- Practice address
- 1421 N State St
Suite 203
Jackson, MS 39202-1658 - Phone
- (601) 355-1234
- Fax
- (601) 354-3881
- NPI assigned
- Oct 11, 2005
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gastroenterology Physician | 207RG0100X | 06744 | MS | Primary |
Addresses
Primary practice location
1421 N State St
Suite 203
Jackson, MS 39202-1658
Mailing address
1421 N State St
Suite 203
Jackson, MS 39202-1658
Phone (601) 355-1234
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00115725 | Medicaid | MS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 06744 | MS | MD | Gastroenterology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1128988800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1218672000000",
"number": "1649268822",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1421 N STATE ST",
"address_2": "SUITE 203",
"city": "JACKSON",
"state": "MS",
"postal_code": "392021658",
"telephone_number": "601-355-1234",
"fax_number": "601-354-3881"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1421 N STATE ST",
"address_2": "SUITE 203",
"city": "JACKSON",
"state": "MS",
"postal_code": "392021658",
"telephone_number": "601-355-1234",
"fax_number": "601-354-3881"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LONG",
"first_name": "BILLY",
"middle_name": "W",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-10-11",
"last_updated": "2008-08-14",
"status": "A"
},
"taxonomies": [
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "MS",
"license": "06744",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00115725",
"state": "MS"
}
],
"endpoints": [],
"other_names": []
}Other providers in Jackson, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.