Mary C. Long, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

490 Issued in MS

Practice address

114 N Hickory St
Aberdeen, MS 39730-2648

Phone

(662) 369-2444

Fax

(662) 369-7223

NPI assigned

Jul 27, 2007

Last updated

Jul 31, 2009By 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 1

Other names 1

• Connie C. Long Professional name

Medicare fee-for-service enrollment

Enrolled in MS

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Aberdeen Eye Clinic P a

  • Optometrist
  • Aberdeen, MS
  • NPI 1003851304
  Authorized official Same address or phone

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

{
    "created_epoch": "1185494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1248998400000",
    "number": "1932399730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 N HICKORY ST",
            "city": "ABERDEEN",
            "state": "MS",
            "postal_code": "397302648",
            "telephone_number": "662-369-2444",
            "fax_number": "662-369-7223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 N HICKORY ST",
            "city": "ABERDEEN",
            "state": "MS",
            "postal_code": "397302648",
            "telephone_number": "662-369-2444",
            "fax_number": "662-369-7223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONG",
        "first_name": "MARY",
        "middle_name": "C.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-27",
        "last_updated": "2009-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MS",
            "license": "490",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00087903",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CONNIE",
            "last_name": "LONG",
            "middle_name": "C.",
            "credential": "O.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Valerie Long, NURSE PRACTITIONER
• Luezarah Robinson Healthcare Services
• Arleader Kimberly Lyons, LCSW
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• Optometrist in Aberdeen, MS
• Providers in Aberdeen, MS by specialty
• Optometrist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.