Individual provider Active NPI

Thomas Joseph Longo, PSY.D.

  • Clinical Psychologist
  • Fort Bragg, NC
National Provider Identifier
1750552758
Registry record updated Apr 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
1481 Issued in AL
Practice address
2817 Reilly St
Womack Army Medical Center
Fort Bragg, NC 28310-7324
Phone
(910) 907-8922
NPI assigned
Mar 18, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 11, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 1481 AL Primary

Addresses

Primary practice location

2817 Reilly St
Womack Army Medical Center
Fort Bragg, NC 28310-7324

Mailing address

2904 Marcus James Dr
Fayetteville, NC 28306-4610
Phone (910) 488-1865

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220520000434 FL Practitioner - Clinical Psychologist 8820475403 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Debra K Carter PH D and Associates PAGroup PAC ID 0547234379, 9 clinicians

Practice addresses (Care Compare)

4835 27TH St W
Suite 125
Bradenton, FL 34207-1759
Phone (941) 753-0064

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1481ALMDSports Physician Chiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Debra K Carter PH D & Associates PA Clinical CurrentSince Jun 1, 2022 Accepting new patients

Locations

4835 27th St W
Ste 125
Bradenton, FL 34207
Phone (941) 753-0064

Networks

  • Freedom Health HMO Network

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.

NPI Registry JSON

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

{
    "created_epoch": "1205798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649635200000",
    "number": "1750552758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2904 MARCUS JAMES DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283064610",
            "telephone_number": "910-488-1865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2817 REILLY ST",
            "address_2": "WOMACK ARMY MEDICAL CENTER",
            "city": "FORT BRAGG",
            "state": "NC",
            "postal_code": "283107324",
            "telephone_number": "910-907-8922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONGO",
        "first_name": "THOMAS",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-03-18",
        "last_updated": "2022-04-11",
        "certification_date": "2022-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "AL",
            "license": "1481",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Bragg, NC

Sources for this page

Verify at the official NPI Registry.