Active NPI
Mary Catherine Long, PH.D.
- Other Specialist/Technologist
- Pelham, AL
National Provider Identifier
1669816070
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Other Specialist/Technologist
- License
- 11003RE
- Practice address
- 1709 Woodview Cir
Pelham, AL 35124-1021 - Phone
- (205) 541-3679
- Fax
- (205) 444-9190
- NPI assigned
- Apr 29, 2013
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Other Specialist/Technologist | 246Z00000X | 11003RE | GA | Primary |
Addresses
Primary practice location
1709 Woodview Cir
Pelham, AL 35124-1021
Mailing address
1709 Woodview Cir
Pelham, AL 35124-1021
Phone (205) 541-3679
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)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11003RE | GA | MD | Other Specialist/Technologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1367193600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1367193600000",
"number": "1669816070",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1709 WOODVIEW CIR",
"city": "PELHAM",
"state": "AL",
"postal_code": "351241021",
"telephone_number": "205-541-3679",
"fax_number": "205-444-9190"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1709 WOODVIEW CIR",
"city": "PELHAM",
"state": "AL",
"postal_code": "351241021",
"telephone_number": "205-541-3679",
"fax_number": "205-444-9190"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LONG",
"first_name": "MARY",
"middle_name": "CATHERINE",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-04-29",
"last_updated": "2013-04-29",
"status": "A"
},
"taxonomies": [
{
"code": "246Z00000X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Other",
"state": "GA",
"license": "11003RE",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pelham, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.