NPIMap

Individual provider Active NPI

Timothy R. Long, M.D.

  • Family Medicine Physician
  • Bowling Green, KY
National Provider Identifier
1699743567
Registry record updated Dec 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
33989 Issued in KY
Practice address
1320 Andrea St
Bowling Green, KY 42104-3334
Phone
(270) 746-5455
Fax
(270) 746-5688
NPI assigned
Mar 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 33989 KY Primary

Addresses

Primary practice location

1320 Andrea St
Bowling Green, KY 42104-3334

Mailing address

5 Chestnut Hill CT
Bowling Green, KY 42103-7002
Phone (270) 746-5455

Other identifiers 3

IdentifierTypeStateIssuer
000000216368OtherANTHEM BLUE CROSS & BLUE
35L1OtherKYANTHEM BC/BS
64339898MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060106000060 KY Practitioner - Family Practice 8628049913 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Louisville School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Tim Long MD PSCGroup PAC ID 7810968104, 3 clinicians

Practice addresses (Care Compare)

1320 Andrea St
Bowling Green, KY 42104-3334
Phone (270) 746-5455

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of tissue1-10
Removal of skin lesions22
Removal of nail tissue1-10
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Tim Long M.D., PSC CurrentSince Jul 1, 2002 Accepting new patients
NP Group of Tim Long MD PSC CurrentSince Jul 1, 2002 Accepting new patients
Hospitalists at Greenview Regional Hospital LLC PastSince Sep 14, 2007 Accepting new patients

Locations

1320 Andrea St
Bowling Green, KY 42104
Phone (270) 746-5455

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EBCCBA

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1141776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1261008000000",
    "number": "1699743567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 CHESTNUT HILL CT",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421037002",
            "telephone_number": "270-746-5455",
            "fax_number": "270-746-5688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1320 ANDREA ST",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421043334",
            "telephone_number": "270-746-5455",
            "fax_number": "270-746-5688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONG",
        "first_name": "TIMOTHY",
        "middle_name": "R.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-08",
        "last_updated": "2009-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "33989",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE CROSS & BLUE",
            "identifier": "000000216368",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC/BS",
            "identifier": "35L1",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64339898",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bowling Green, KY

Sources for this page

Verify at the official NPI Registry.