Mitchell Long, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PTA. 08768 Issued in OH

Practice address

328 W Vine St
Edgerton, OH 43517-9600

Phone

(419) 298-2321

NPI assigned

Nov 22, 2012

Last updated

Nov 22, 2012By the provider in NPPES

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

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

{
    "created_epoch": "1353542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353542400000",
    "number": "1790029247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21786 SWITZER RD",
            "city": "DEFIANCE",
            "state": "OH",
            "postal_code": "435129732",
            "telephone_number": "740-975-4464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "328 W VINE ST",
            "city": "EDGERTON",
            "state": "OH",
            "postal_code": "435179600",
            "telephone_number": "419-298-2321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONG",
        "first_name": "MITCHELL",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-11-22",
        "last_updated": "2012-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "OH",
            "license": "PTA. 08768",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca Dee Hand
• Patricia Hartman
• Richard Lowell Hurley
• Cynthia Lynn Jones
• Karrie A La Londe
• Park View Operating Company LLC
• Park View Operating Company LLC
• Park View Operating Company LLC
• Peregrine Health Services of Edgerton,LLC (Park View Nursing Center)
• PGN Op Park LLC (Park View Nursing Center)

• Physical Therapy Assistant in Edgerton, OH
• Providers in Edgerton, OH by specialty
• Physical Therapy Assistant in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2012; 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.