Emma L. Long, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

01045980A Issued in IN

Practice address

1500 Provident Dr
Suite a
Warsaw, IN 46580-3291

Phone

(574) 372-7637

NPI assigned

Dec 27, 2005

Last updated

Jun 24, 2013By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1135641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372032000000",
    "number": "1902883424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 PROVIDENT DR",
            "address_2": "SUITE A",
            "city": "WARSAW",
            "state": "IN",
            "postal_code": "465803291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 PROVIDENT DR",
            "address_2": "SUITE A",
            "city": "WARSAW",
            "state": "IN",
            "postal_code": "465803291",
            "telephone_number": "574-372-7637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONG",
        "first_name": "EMMA",
        "middle_name": "L.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-27",
        "last_updated": "2013-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01045980A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000241419",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5061595",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIANS HEALTH PLAN",
            "identifier": "5887",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200141330",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jesenia Guadalupe Linares Moctezuma, RDH
• Amslie Lippencott
• Lisa E Rostvold (Blue Moon Shoes)
• Tara Janae Little, FNP
• Daniel Louis Loney, D.O.
• Sadra Long
• Braydon Lowe
• Jacqueline Ann Lowe, RPH.
• Muriel Luft, MSW
• Timothy P. Lund, MD

• Family Medicine Physician in Warsaw, IN
• Providers in Warsaw, IN by specialty
• Family Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2013; 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.