DR. MITCHELL D LONG (NPI# 1760405534) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760405534 |
| Entity Type | Individual |
| Full Name | DR. MITCHELL D LONG |
| Credential | DO |
| Practice Address |
1512 12th Ave Rd Nampa ID 83686-6008 |
| Mailing Address |
2463 Eastdale Dr Boise ID 83712-6724 |
| Practice Telephone | 2084635100 |
| Mailing Telephone | 2083432587 |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | 0-273 | ID | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255945655 | Mitchell J Long | Student in an Organized Health Care Education/Training Program | 30 Allens Creek Rd, Rochester, NY 14618-3228 | 2020-09-02 |
| 1164876231 | Mitchell Long | Student in an Organized Health Care Education/Training Program | 2201 Hempstead Tpke, East Meadow, NY 11554-1859 | 2016-04-14 |
| 1790029247 | Mitchell Long | Physical Therapy Assistant | 328 W Vine St, Edgerton, OH 43517-9600 | 2012-11-22 |
| Street Address |
1512 12TH AVE RD |
| City | NAMPA |
| State | ID |
| Zip Code | 83686-6008 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013905355 | Steve Edward Roberts | Anesthesiology | 1512 12th Ave Rd, Nampa, ID 83686-6008 | 2005-10-11 |
| 1295141992 | Jane Stroebel | Pharmacist | 1512 12th Ave Rd, Nampa, ID 83686-6008 | 2014-07-02 |
| 1881973899 | Olawale Olaniyi | Internal Medicine | 1512 12th Ave Rd, Nampa, ID 83686-6008 | 2011-08-08 |
| 1730407461 | Sound Physicians of Idaho | Family Medicine | 1512 12th Ave Rd, Nampa, ID 83686-6008 | 2010-05-05 |
| 1821229279 | Patrick Daniel Vargas Villazon | Internal Medicine | 1512 12th Ave Rd, Nampa, ID 83686-6008 | 2009-08-03 |
| 1275772758 | James M Ineck | Pharmacist | 1512 12th Ave Rd, Nampa, ID 83686-6008 | 2009-02-06 |
| 1336388974 | Jesse Vanwart | Pharmacist | 1512 12th Ave Rd, Nampa, ID 83686-6008 | 2009-02-04 |
| 1942461850 | Joseph M. Mortensen | Anesthesiology | 1512 12th Ave Rd, Nampa, ID 83686-6008 | 2008-06-23 |
| 1235260845 | Donald G Rau | Radiology | 1512 12th Ave Rd, Nampa, ID 83686-6008 | 2007-03-07 |
| 1083751366 | Jeffrey Wayne Grossman | Radiology | 1512 12th Ave Rd, Nampa, ID 83686-6008 | 2007-01-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184255960 | Kristine Lynn Fitts-eisenbrandt | Social Worker | 270 W. Gerogia Ave., Nampa, ID 83686 | 2020-01-30 |
| 1669025706 | Vitality Family Chiropractic, Pllc | Chiropractor | 3189 E Greenhurst Rd, Nampa, ID 83686 | 2019-07-18 |
| 1871150185 | King's Peak Investments, Inc. | Substance Abuse Rehabilitation Facility | 8898 Idaho 45, Nampa, ID 83686 | 2019-05-22 |
| 1154805786 | Jmj Nampa LLC | Dentist | 914 12th Ave Rd, Nampa, ID 83686 | 2018-09-19 |
| 1518448703 | Michel Cox | Pharmacy Technician | 2219 12th Ave S, Nampa, ID 83686 | 2018-08-24 |
| 1437504909 | 5 Peppers Inc | Family Medicine | 217 W. Georgia Ave. Ste 120, Nampa, ID 83686 | 2016-05-03 |
| 1811369549 | Anna Stoia | Physician Assistant | 4401 E. Tuscany Ave., Nampa, ID 83686 | 2015-10-21 |
| 1144699307 | Jamie Green | Social Worker | 112 12th Avenue Rd., Nampa, ID 83686 | 2015-09-17 |
| 1174927933 | Bower Chiropractic Inc | Chiropractor | 304 12th Ave Rd, Nampa, ID 83686 | 2014-10-22 |
| 1285037093 | Rosemary Phelps | Registered Nurse | 353 W. Iowa, Nampa, ID 83686 | 2014-10-07 |
| Find all providers in zip 83686 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780104851 | Cep America, LLC | Emergency Medicine | 4300 E. Flamingo Ave, Nampa, ID 83687-9203 | 2017-06-21 |
| 1962799460 | Tyler James Harris | Emergency Medicine | 1510 12th Ave Rd Ste 100, Nampa, ID 83686 | 2011-07-05 |
| 1336372515 | Lauren Beth Gibson | Emergency Medicine | 4424 E Flamingo Avet, Ste 110, Nampa, ID 83687 | 2009-09-03 |
| 1013094820 | Ann M Weiss | Emergency Medicine | 700 Caldwell Blvd, Primary Health Medical Group, Nampa, ID 83651-1707 | 2006-11-01 |
| 1558307280 | John Mullins | Emergency Medicine | 1115 12th Ave Rd, Nampa, ID 83686-5738 | 2006-06-21 |
| 1093368961 | Dispatchhealth-idaho PC | Emergency Medicine | 1105 2nd St S Ste 100, Nampa, ID 83651-3911 | 2019-07-19 |
| 1982064192 | Cep America, LLC | Emergency Medicine | 4300 E Flamingo Ave, Nampa, ID 83687-9203 | 2016-03-01 |
| 1629438833 | Cep America, LLC | Emergency Medicine | 1510 12th Ave Rd Ste 100, Nampa, ID 83686-6008 | 2016-03-01 |
| 1801074232 | Elizabeth A Davis | Emergency Medicine | 215 E Hawaii Ave, Nampa, ID 83686-6011 | 2008-02-07 |
| 1174745582 | Richard C Ballantyne | Emergency Medicine | 215 E Hawaii Ave, Nampa, ID 83686-6011 | 2007-05-03 |
| Find all providers in NAMPA | ||||
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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.