Longevity Health and Wellness

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

LONGEVITY HEALTH AND WELLNESS

Practice address

3008 W Willow Knolls Dr
Peoria, IL 61614-1083

Phone

(309) 678-0963

NPI assigned

Sep 5, 2022

Last updated

Oct 12, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Brandie Long, D.C.NPI 1356849772

Title

Owner/Chiropractor

Phone

(309) 678-0963

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Brandie Long

  • Chiropractor
  • Peoria, IL
  • NPI 1356849772
  NPD Authorized official

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

{
    "created_epoch": "1662336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665532800000",
    "number": "1770204117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8511 COUNTRY VIEW DR",
            "city": "MANITO",
            "state": "IL",
            "postal_code": "615468619",
            "telephone_number": "309-678-0963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3008 W WILLOW KNOLLS DR",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616141083",
            "telephone_number": "309-678-0963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LONGEVITY HEALTH AND WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-05",
        "last_updated": "2022-10-12",
        "certification_date": "2022-10-12",
        "status": "A",
        "authorized_official_last_name": "LONG",
        "authorized_official_first_name": "BRANDIE",
        "authorized_official_title_or_position": "OWNER/CHIROPRACTOR",
        "authorized_official_telephone_number": "309-678-0963",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brandie Long
• Gregory D Long II, DMD
• Greta Long
• Kathy Long
• Nancy Long
• Anne Look, APN
• Kimberly K Lopez
• Robert Walter Lopez
• Shannon R Lopiccolo, PT
• Lori Bushell Counseling LLC

• Chiropractor in Peoria, IL
• Providers in Peoria, IL by specialty
• Chiropractor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2022; 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.