Active NPI
Edward R Long, PT
- Physical Therapist
- Mount Pleasant, SC
National Provider Identifier
1750901252
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2081
- Practice address
- 1476 Long Grove Dr Ste 1
Mount Pleasant, SC 29464-7571 - Phone
- (843) 216-3534
- NPI assigned
- Apr 24, 2020
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 2081 | SC | Primary |
Addresses
Primary practice location
1476 Long Grove Dr Ste 1
Mount Pleasant, SC 29464-7571
Mailing address
453 Commonwealth Rd
Mt Pleasant, SC 29466-8326
Phone (843) 568-9306
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1587686400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1587686400000",
"number": "1750901252",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "453 COMMONWEALTH RD",
"city": "MT PLEASANT",
"state": "SC",
"postal_code": "294668326",
"telephone_number": "843-568-9306"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1476 LONG GROVE DR STE 1",
"city": "MOUNT PLEASANT",
"state": "SC",
"postal_code": "294647571",
"telephone_number": "843-216-3534"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LONG",
"first_name": "EDWARD",
"middle_name": "R",
"name_prefix": "Mr.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-04-24",
"last_updated": "2020-04-24",
"certification_date": "2020-04-24",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "SC",
"license": "2081",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mount Pleasant, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.