Active NPI
Carolyn Marie Long, DO
- Family Medicine Physician
- Tulsa, OK
National Provider Identifier
1720518095
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 7119
- Practice address
- 2321 E 3Rd St
Tulsa, OK 74104-1831 - Phone
- (918) 622-0641
- Fax
- (918) 442-2036
- NPI assigned
- Jun 19, 2017
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 7119 | OK | Primary |
Addresses
Primary practice location
2321 E 3Rd St
Tulsa, OK 74104-1831
Mailing address
2321 E 3Rd St
Tulsa, OK 74104-1831
Phone (918) 622-0641
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OK
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230914001461 | OK | Order and Referring Only - Family Practice | 9436409695 |
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Community Health Connection, Inc.
Practice addresses (Care Compare)
9912 E 21St St
Tulsa, OK 74129-1620
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7119 | OK | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Community Health Connection Inc | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Federally Qualified Health Center (FQHC)
- Tulsa, OK
- NPI 1194730911
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Tulsa, OK
- NPI 1629057229
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1497830400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1683331200000",
"number": "1720518095",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2321 E 3RD ST",
"city": "TULSA",
"state": "OK",
"postal_code": "741041831",
"telephone_number": "918-622-0641",
"fax_number": "918-442-2036"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2321 E 3RD ST",
"city": "TULSA",
"state": "OK",
"postal_code": "741041831",
"telephone_number": "918-622-0641",
"fax_number": "918-442-2036"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LONG",
"first_name": "CAROLYN",
"middle_name": "MARIE",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-06-19",
"last_updated": "2023-05-06",
"certification_date": "2023-05-06",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "OK",
"license": "7119",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Tulsa, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.