Individual provider Active NPI

Cory R. Long, MD

  • Emergency Medicine Physician
  • Danville, IN
National Provider Identifier
1689806432
Registry record updated Mar 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
01069779A Issued in IN
Practice address
1000 E Main St
Danville, IN 46122-1948
Phone
(317) 745-4451
Fax
(317) 718-6740
NPI assigned
Aug 12, 2009
Last updated
Mar 29, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 01069779A IN Primary
Emergency Medicine Physician 207P00000X 097150 OH

Addresses

Primary practice location

1000 E Main St
Danville, IN 46122-1948

Mailing address

1000 E Main St
Danville, IN 46122-1948
Phone (317) 745-4451

Other practice location 1

11700 N Meridian St
Carmel, IN 46032-4656
Phone (317) 688-3140

Other identifiers 3

IdentifierTypeStateIssuer
201153410MedicaidIN
000000823438OtherINANTHEM PIN
0076978MedicaidOH

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address clong231422@direct-PRD.stelizabeth.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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 1

Enrollment IDStateProvider typePAC IDDetails
I20131021000375 IN Practitioner - Emergency Medicine 1456521095 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
097150OHMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hendricks County Hospital CurrentSince Oct 1, 2020 Accepting new patients
Hendricks County Hospital Current Accepting new patients
Hendricks County Hospital CurrentSince Oct 1, 2020 Accepting new patients
Indiana University Health Care Associates, Inc CurrentSince Sep 1, 2013 Accepting new patients
Hendricks County Hospital Past Accepting new patients
Hendricks County Hospital Past Accepting new patients
Danville Family Eye Care LLC Past Accepting new patients
Miami Valley Emergency Specialists, LLC Emergency Medicine Past Accepting new patients

Locations

5208 Reliable Pkwy
Chicago, IL 60686

8244 E US Highway 36
Ste 1100
Avon, IN 46123
Phone (317) 272-7500

8244 E US Highway 36
Ste 1340
Avon, IN 46123
Phone (317) 520-5510

5492 N Ronald Reagan Pkwy
Brownsburg, IN 46112
Phone (317) 745-6139

11700 N Meridian St
Carmel, IN 46032
Phone (317) 688-2000

1000 E Main St
Danville, IN 46122
Phone (317) 745-3420

1701 N Senate Blvd
Bldg C6
Indianapolis, IN 46202
Phone (913) 962-2000

250 N Shadeland Ave
Ste 130
Indianapolis, IN 46219
Phone (317) 962-4836

1100 Southfield Dr
Ste 1370
Plainfield, IN 46168
Phone (317) 837-5570

Interoperability endpoints

  • Direct secure messaging: clong231422@direct-prd.stelizabeth.com
  • FHIR API: https://sehproxy.stelizabeth.com/arr-fhir/api/FHIR/R4

Organizations & group practices 8

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1250035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616976000000",
    "number": "1689806432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 E MAIN ST",
            "city": "DANVILLE",
            "state": "IN",
            "postal_code": "461221948",
            "telephone_number": "317-745-4451",
            "fax_number": "317-718-6740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 E MAIN ST",
            "city": "DANVILLE",
            "state": "IN",
            "postal_code": "461221948",
            "telephone_number": "317-745-4451",
            "fax_number": "317-718-6740"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11700 N Meridian St",
            "address_purpose": "LOCATION",
            "city": "Carmel",
            "state": "IN",
            "postal_code": "460324656",
            "country_code": "US",
            "telephone_number": "317-688-3140",
            "fax_number": "317-688-2664",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LONG",
        "first_name": "CORY",
        "middle_name": "R.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-08-12",
        "last_updated": "2021-03-29",
        "certification_date": "2021-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IN",
            "license": "01069779A",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "097150",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201153410",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PIN",
            "identifier": "000000823438",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0076978",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "clong231422@direct-PRD.stelizabeth.com",
            "affiliation": "N",
            "address_1": "1000 E Main St",
            "city": "Danville",
            "state": "IN",
            "country_code": "US",
            "postal_code": "461221948",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Danville, IN

Sources for this page

Verify at the official NPI Registry.