Individual provider Active NPI

William Wesley Long Jr., DO

  • Family Medicine Physician
  • Toledo, OH
National Provider Identifier
1710502794
Registry record updated Sep 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
34.016368 Issued in OH
Practice address
2865 N Reynolds Rd Ste 170
Toledo, OH 43615-2076
Phone
(419) 578-4280
NPI assigned
Jun 15, 2020
Last updated
Sep 30, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2024

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 34.016368 OH Primary

Addresses

Primary practice location

2865 N Reynolds Rd Ste 170
Toledo, OH 43615-2076

Mailing address

2865 N Reynolds Rd Ste 170
Toledo, OH 43615-2076
Phone (419) 578-4280

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20241018001121 OH Practitioner - Family Practice 3678996923 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Marian University College of Osteopathic Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Promedica Central PhysiciansGroup PAC ID 2365348190, 785 clinicians

Practice addresses (Care Compare)

2865 N Reynolds Rd
Suite 160
Toledo, OH 43615-2076
Phone (419) 578-4260

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Promedica Central Physicians Family Medicine CurrentSince Aug 26, 2024 Accepting new patients
Promedica Central Physicians CurrentSince Aug 26, 2024 Accepting new patients

Locations

2109 Hughes Dr
Ste 450
Toledo, OH 43606
Phone (419) 251-3112

2865 N Reynolds Rd
Ste 160
Toledo, OH 43615
Phone (419) 578-4260

Interoperability endpoints

  • Direct secure messaging: wlong276049@direct.promedica.org

Organizations & group practices 2

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.

Hospital & facility affiliations 2

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": "1592179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727654400000",
    "number": "1710502794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2865 N REYNOLDS RD STE 170",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436152076",
            "telephone_number": "419-578-4280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2865 N REYNOLDS RD STE 170",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436152076",
            "telephone_number": "419-578-4280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONG",
        "first_name": "WILLIAM",
        "middle_name": "WESLEY",
        "name_suffix": "Jr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-15",
        "last_updated": "2024-09-30",
        "certification_date": "2024-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "34.016368",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

Verify at the official NPI Registry.