Mitchell David Long, DC

Primary specialty

Rehabilitation ChiropractorTaxonomy code 111NR0400X

License

16369 Issued in TX

Practice address

1315 Sam Bass Cir
Round Rock, TX 78681-2932

Phone

(512) 284-9278

NPI assigned

Feb 12, 2025

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

State licenses

Practice roles

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.

• Wagenblast Chiropractic, PLLC

  • Sports Physician Chiropractor
  • Round Rock, TX
  • NPI 1235418666

  Rehabilitation

  NPD (past)

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

{
    "created_epoch": "1739318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739318400000",
    "number": "1750196101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1334 BECCA TEAL PL",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786812242",
            "telephone_number": "512-217-5194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1315 SAM BASS CIR",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786812932",
            "telephone_number": "512-284-9278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONG",
        "first_name": "MITCHELL",
        "middle_name": "DAVID",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-02-12",
        "last_updated": "2025-02-12",
        "certification_date": "2025-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "TX",
            "license": "16369",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lone Star Physical Therapy Services, LLC
• Lonestar Pat Associates PA
• Chad J Long, M.D.
• Dorothy Long, LPC
• Marcy Willard Long, PA-C
• Kelli Longoria, FNP
• Mario Abel Longoria, M.D.
• Virginie Longpre, CCC-SLP
• Jennifer Lopatowski, BCBA
• Maria Fernanda Lopez Salazar

• Rehabilitation Chiropractor in Round Rock, TX
• Providers in Round Rock, TX by specialty
• Rehabilitation Chiropractor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2025; 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.