Mitchell D Long, DO

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

0-273 Issued in ID

Practice address

1512 12TH Ave Rd
Nampa, ID 83686-6008

Phone

(208) 463-5100

NPI assigned

Jul 25, 2006

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)

Enrolled

Credentials

Doctor of Osteopathy

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.

• Premier Emergency Physicians of Idaho Medical Group

  • Emergency Medicine Physician
  • Nampa, ID
  • NPI 1942259965
  NPD (past)
• Treasure Valley Emergency Physicians

  • Emergency Medicine Physician
  • Nampa, ID
  • NPI 1053360065
  NPD (past)
• Churchill Mangat Emergency Group PC

  • Emergency Medicine Physician
  • Fallon, NV
  • NPI 1881905149
  NPD (past)
• Columbia Valley Emergency Physicians LLC

  • Emergency Medicine Physician
  • Kennewick, WA
  • NPI 1811946056
  NPD (past)
• PHS Indian Hospital

  • General Acute Care Hospital
  • Red Lake, MN
  • NPI 1508809765
  NPD (past)

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1760405534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2463 EASTDALE DR",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837126724",
            "telephone_number": "208-343-2587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1512 12TH AVE RD",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836866008",
            "telephone_number": "208-463-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONG",
        "first_name": "MITCHELL",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "ID",
            "license": "0-273",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lloyd, Brinegar, Short and Associates
• Julia Ann Lockhart, CNM
• Robin Lockhart
• Samuel Darcy Loescher, DO
• Hunter Long
• Aleja O Longoria
• Emily Ann Looze, DMS, PA-C
• Alexandrea Lakay Lopez
• Todd Andrew Loree, MPT
• Loren R. Hartley, D.M.D., P.C.

• Emergency Medicine Physician in Nampa, ID
• Providers in Nampa, ID by specialty
• Emergency Medicine Physician in Idaho

• 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.