Douglas Jess Long, MS ES LAT ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

Practice address

1115 S Cottonwood St
North Platte, NE 69101-6108

Phone

(308) 696-7456

Fax

(308) 696-8637

NPI assigned

Feb 14, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

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

{
    "created_epoch": "1171411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1720121619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1115 S COTTONWOOD ST",
            "city": "NORTH PLATTE",
            "state": "NE",
            "postal_code": "691016108",
            "telephone_number": "308-696-7456",
            "fax_number": "308-696-8637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1115 S COTTONWOOD ST",
            "city": "NORTH PLATTE",
            "state": "NE",
            "postal_code": "691016108",
            "telephone_number": "308-696-7456",
            "fax_number": "308-696-8637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONG",
        "first_name": "DOUGLAS",
        "middle_name": "JESS",
        "credential": "MS ES LAT ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Athletic Trainer in North Platte, NE
• Providers in North Platte, NE by specialty
• Athletic Trainer in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.