Active NPI
Michael C Long, DPT
- Physical Therapist
- Green River, WY
National Provider Identifier
1699320606
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT-1900
- Practice address
- 330 Upland Way
Green River, WY 82935-6401 - Phone
- (307) 875-4654
- Fax
- (307) 875-4641
- NPI assigned
- Aug 6, 2019
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT-1900 | WY | Primary |
Addresses
Primary practice location
330 Upland Way
Green River, WY 82935-6401
Mailing address
2002 W Sunset Dr Ste 1
Riverton, WY 82501-2285
Phone (307) 856-7021
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1565049600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1565049600000",
"number": "1699320606",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2002 W SUNSET DR STE 1",
"city": "RIVERTON",
"state": "WY",
"postal_code": "825012285",
"telephone_number": "307-856-7021",
"fax_number": "307-856-5546"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "330 UPLAND WAY",
"city": "GREEN RIVER",
"state": "WY",
"postal_code": "829356401",
"telephone_number": "307-875-4654",
"fax_number": "307-875-4641"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LONG",
"first_name": "MICHAEL",
"middle_name": "C",
"name_prefix": "Mr.",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-08-06",
"last_updated": "2019-08-06",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WY",
"license": "PT-1900",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Green River, WY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.