Jerry Lee Long Jr.

Primary specialty

Customized Equipment (DME)Taxonomy code 332BC3200X

Practice address

6654 Bitteroot LN
Saint Louis, MO 63134-1451

Phone

(813) 494-1282

NPI assigned

Aug 12, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1565568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565568000000",
    "number": "1881240349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 34086",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631340086",
            "telephone_number": "813-494-1282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6654 BITTEROOT LN",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631341451",
            "telephone_number": "813-494-1282"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5474 Williams Rd Ste 1B",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336109345",
            "country_code": "US",
            "telephone_number": "813-494-1282",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LONG",
        "first_name": "JERRY",
        "middle_name": "LEE",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-08-12",
        "last_updated": "2019-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.dreamhairnation.com",
            "affiliation": "N",
            "address_1": "6654 Bitteroot Ln",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631341451",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Bridget Long, PHD
• Carol A Long, LPC
• Emily Ann Long
• Gillian Rose Long, DO
• Jeff Long
• Justin M Long, MD
• Katherine Long, MAC
• Katherine Ding Long
• Kelley Long
• Lucille Long

• Customized Equipment (DME) in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Customized Equipment (DME) in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2019; 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.