MR. JAMES ELDON LONG SR. (NPI# 1124165626) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124165626 |
| Entity Type | Individual |
| Full Name | MR. JAMES ELDON LONG SR. |
| Credential | PA-C |
| Practice Address |
300a Nw 1st Ave Williston FL 32696-2006 |
| Mailing Address |
300a N,w, 1st Ave Williston FL 32696-6262 |
| Practice Telephone | 3525290966 |
| Practice Fax Number | 3525290967 |
| Mailing Telephone | 3525290966 |
| Mailing Fax Number | 3525290967 |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2014-04-29 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA2538 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | BCBS | Y09KU | 01 |
| FL | 004428900 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841660347 | James D Long | Nurse Practitioner | 2462 Sutherland Ct, Cape Coral, FL 33991-3188 | 2015-09-28 |
| 1144537994 | James Stanley Long | Social Worker | 7540 Memorial Parkway S, Suite W, Huntsville, AL 35802-6522 | 2010-08-31 |
| 1083949267 | James A Long | Radiology | 503 Eisenhower Drive, Savannah, GA 31406 | 2009-10-06 |
| 1538375613 | James Spencer Long | Family Medicine | 404 Carlyle St, Alma, NE 68920-2078 | 2007-05-15 |
| 1649483595 | James Christopher Long | Occupational Therapist | 1119 Lake Bluff Circle, Louisville, KY 40245 | 2007-05-08 |
| 1952527194 | James A Long Jr. | Social Worker | 6 Naughright Rd, Hackettstown, NJ 07840-5610 | 2007-04-17 |
| 1598880429 | James Percy Long IIi | Physical Therapist | 1730 W. 25th St., Cleveland, OH 44113-3108 | 2007-03-20 |
| 1508928326 | James Phillip Long | Podiatrist | 210 Patricia Avenue, Dunedin, FL 34698-8124 | 2006-12-15 |
| 1487720827 | James Albert Long II | Optometrist | 1221 Medical Park Dr, Fort Wayne, IN 46825-5827 | 2006-11-28 |
| 1174606867 | James O Long | Dentist | 22026 Highland Knolls, Katy, TX 77450 | 2006-10-24 |
| Street Address |
300A NW 1ST AVE |
| City | WILLISTON |
| State | FL |
| Zip Code | 32696-2006 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508352915 | Tyler Greg Egan | Family Medicine | 300a Nw 1st Ave, Williston, FL 32696-2006 | 2018-07-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962060939 | Quick Care Med LLC | Non-Pharmacy Dispensing Site | 517 W Noble Ave, Williston, FL 32696 | 2019-06-04 |
| 1346770930 | Michelle Yvette Dempsey | Home Health Aide | 931 Ne 207th Ave, Williston, FL 32696 | 2017-06-15 |
| 1801157185 | Pratibha Lumb | Family Medicine | 630 N. Main Street, Williston, FL 32696 | 2012-06-04 |
| 1821261306 | Raymond T Webber | Dentist | 610 Sw 1st Ave, Williston, FL 32696 | 2008-04-07 |
| 1003912635 | Jeremie Joseph Young | General Practice | 125 Sw 7th Street, Williston, FL 32696 | 2006-09-14 |
| 1073514543 | Kolli Prabhakara Reddy | Family Medicine | 520 Sw 5th Ave, Williston, FL 32696 | 2005-08-09 |
| 1578584884 | Winn Dixie Stores Inc | Durable Medical Equipment & Medical Supplies | 727 W Noble Ave, Williston, FL 32696-1515 | 2006-07-21 |
| 1841631249 | Lawrence C Rush Jr. | Pharmacist | 727 W Noble Ave, Williston, FL 32696-1515 | 2013-07-13 |
| 1952401648 | Teresa Sever | Pharmacist | 727 W Noble Ave, Williston, FL 32696-1515 | 2006-09-23 |
| 1497060784 | Priscilla Smith | Social Worker | 18990 Ne 49th St, Williston, FL 32696-1555 | 2010-08-11 |
| Find all providers in zip 32696 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558702357 | Elizabeth Kathryn Loscalzo | Physician Assistant | 28 Park Ave, Williston, VT 05495-9701 | 2013-07-10 |
| 1831458744 | Carissa Annette Niederhauser | Physician Assistant | 1301 15th Ave W, Williston, ND 58801-3821 | 2012-05-11 |
| 1700972486 | Molly Backup | Physician Assistant | 28 Park Ave, Williston, VT 05495 | 2006-10-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255931325 | Jonathan Thomas Nusbaum | Physician Assistant | 26160 Angelica Rd, Punta Gorda, FL 33955-1419 | 2020-10-28 |
| 1235738659 | Kevin Marcus Luks | Physician Assistant | 10701 Santa Fe Dr, Hollywood, FL 33026-4955 | 2020-10-19 |
| 1245839521 | Stephanie Clay | Physician Assistant | 3455 Rose Mallow Loop, Oviedo, FL 32766-6648 | 2020-10-19 |
| 1104423755 | Lou Joseph Schneggenburger | Physician Assistant | 10115 Forest Hill Blvd Ste 100, Wellington, FL 33414-6178 | 2020-10-07 |
| 1235744582 | Stephanie Graham | Physician Assistant | 1053 Bernice Rd, Rockledge, FL 32955-2201 | 2020-09-14 |
| 1790399483 | Shyla Imani Kissoon | Physician Assistant | 4830 Nw 7th St, Plantation, FL 33317-1410 | 2020-09-01 |
| 1770193500 | My Physician Online | Physician Assistant | 9540 Nw 23rd St, Coral Springs, FL 33065-4974 | 2020-08-06 |
| 1225647977 | Robert Drew Singleton | Physician Assistant | 17501 Biscayne Blvd Ste 460, Aventura, FL 33160-4806 | 2020-07-29 |
| 1750990974 | Andrea K Webber | Physician Assistant | 8119 Sw State Rd 200, Ocala, FL 34481-3448 | 2020-07-23 |
| 1851919526 | Kyra Panni | Physician Assistant | 3857 Hartwood Ln, Jacksonville, FL 32216-1486 | 2020-07-09 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.