Shannon Olivia Long, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

291794 Issued in CA

Practice address

10780 Santa Monica Blvd Ste 405
Los Angeles, CA 90025-7655

Phone

(310) 234-0300

NPI assigned

Jun 19, 2018

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1529366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536883200000",
    "number": "1992299358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10780 SANTA MONICA BLVD STE 405",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900257655",
            "telephone_number": "310-234-0300",
            "fax_number": "310-234-0304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10780 SANTA MONICA BLVD STE 405",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900257655",
            "telephone_number": "310-234-0300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10780 Santa Monica Blvd Ste 405",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900257655",
            "country_code": "US",
            "telephone_number": "310-234-0300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LONG",
        "first_name": "SHANNON",
        "middle_name": "OLIVIA",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-19",
        "last_updated": "2018-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "291794",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Joseph Long
• Rebecca Long, MD
• Richard Long
• Ryan Michael Long, MD
• Sandra Long, LMFT
• Skylar Long, PA
• Toni Marie Long, LCSW
• William T Long, M.D.
• Matthew Douglass Longacre, M.D.
• Longevity Medical Center

• Physical Therapist in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2018; 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.