EMMA L. LONG (NPI# 1902883424) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902883424 |
| Entity Type | Individual |
| Full Name | EMMA L. LONG |
| Credential | M.D. |
| Practice Address |
1500 Provident Dr Suite A Warsaw IN 46580-3291 |
| Practice Telephone | 5743727637 |
| Enumeration Date | 2005-12-27 |
| Last Update Date | 2013-06-24 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 01045980A | IN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AETNA | 5061595 | 01 | |
| IN | PHYSICIANS HEALTH PLAN | 5887 | 01 |
| IN | ANTHEM | 000000241419 | 01 |
| IN | 200141330 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285196196 | Emma Tinsley-bowles Long | Social Worker | 8786 Northcreek Blvd, Bldg 8 Apt 3, Southaven, MS 38671 | 2019-04-01 |
| 1205440179 | Emma Long | Behavior Technician | 375 Se Broad St Ste A, Southern Pines, NC 28387-6000 | 2020-09-08 |
| 1144483959 | Emma Marie Long | Physician Assistant | 12525 Perkins Rd, Suite B, Baton Rouge, LA 70810-1907 | 2008-07-02 |
| 1770605230 | Emma H Long | Case Manager/Care Coordinator | 238 Summar Dr, Jackson, TN 38301-3906 | 2007-04-04 |
| Street Address |
1500 PROVIDENT DR SUITE A |
| City | WARSAW |
| State | IN |
| Zip Code | 46580-3291 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356324339 | Dawn Theresa Gabrich | Specialist/Technologist | 1500 Provident Dr, Warsaw, IN 46580-3291 | 2005-11-23 |
| 1588141279 | Stephanie Fribley | Physician Assistant | 1500 Provident Dr, Warsaw, IN 46580 | 2018-07-25 |
| 1093233272 | Aaron Turner | Physical Therapist | 1500 Provident Dr, Warsaw, IN 46580-3377 | 2017-09-07 |
| 1710437520 | Audrey Erin Hice | Nurse Practitioner | 1500 Provident Dr, Warsaw, IN 46580-3377 | 2016-10-05 |
| 1295184414 | Mary Meegan | Dietitian, Registered | 1500 Provident Dr, Warsaw, IN 46580-3377 | 2016-06-08 |
| 1902204076 | Medstat | Clinic/Center | 1500 Provident Dr, Suite A, Warsaw, IN 46580-3377 | 2014-12-05 |
| 1528336732 | Nicholas Finken | Specialist/Technologist | 1500 Provident Dr, Warsaw, IN 46580-3377 | 2011-12-02 |
| 1891095881 | Jennifer Lynn Bates | Specialist/Technologist | 1500 Provident Dr, Suite C, Warsaw, IN 46580-3297 | 2010-10-25 |
| 1487960456 | Tyler Lee Wallen | Occupational Therapist | 1500 Provident Dr, Warsaw, IN 46580-3297 | 2010-08-27 |
| 1841459880 | Medstat | Non-Pharmacy Dispensing Site | 1500 Provident Dr, Warsaw, IN 46580-3291 | 2008-06-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346803772 | Amber Rae Parker | Physical Therapy Assistant | 2695 Shelden St., Warsaw, IN 46580 | 2019-04-22 |
| 1194255794 | Tyler Scott Kronk | Counselor | 105 Enterprise Drive, Warsaw, IN 46580 | 2017-06-15 |
| 1306244231 | Indiana Physical Therapy, Inc. | Clinic/Center | 3300 Lake City Hwy., Warsaw, IN 46580 | 2014-12-09 |
| 1922434687 | Yen Thi Vu | Pharmacist | 2400 East Center St, Warsaw, IN 46580 | 2013-09-25 |
| 1982956934 | Marsha Lynn Dreyer | Occupational Therapy Assistant | 300 E. Prairie Street, Warsaw, IN 46580 | 2012-10-15 |
| 1215286109 | Planned Parenthood of Indiana Warsaw | Clinic/Center | 630 S. Buffalo St., Suite 1, Warsaw, IN 46580 | 2012-09-06 |
| 1952636243 | Magdi Gabriel | Orthopaedic Surgery | 2087 Phaesant Ridge Drive, Warsaw, IN 46580 | 2009-10-05 |
| 1316132996 | Assisted Living Concepts Inc | Assisted Living Facility | 425 Chinworth Court, Warsaw, IN 46580 | 2007-09-07 |
| 1598986101 | Ericka Ester Haynes | Occupational Therapist | 900 Provident Drive, Warsaw, IN 46580 | 2007-05-01 |
| 1881819555 | Hartwiger Enterprises, Inc. | Home Health | 3510 Commerce Dr., Warsaw, IN 46580 | 2007-04-16 |
| Find all providers in zip 46580 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205948486 | Warsaw Health System LLC | Family Medicine | 1210 Provident Dr, Suite B, Warsaw, IN 46580-3266 | 2006-08-31 |
| 1730101759 | Robert Theodore Longshore | Family Medicine | 870 Us Hwy 42 W, Warsaw, KY 41095-9323 | 2006-07-25 |
| 1427083435 | Qutubuddin Karamat Dar | Family Medicine | 31 Duncan St, Suite 1, Warsaw, NY 14569-1017 | 2006-07-11 |
| 1598798407 | Ccmh Corporation | Family Medicine | 202 Franklin Street, Warsaw, KY 41095 | 2006-07-07 |
| 1063448231 | Abayomi S Adediran | Family Medicine | 113 S Pine St, Warsaw, NC 28398-1924 | 2006-06-22 |
| 1972546927 | Erin B Jungbauer | Family Medicine | 1210 Provident Drive, Ste B, Warsaw, IN 46580 | 2006-06-14 |
| 1831151869 | Shawn E Kidder | Family Medicine | 2235 Dubois Drive, Warsaw, IN 46580-3212 | 2006-04-05 |
| 1467428318 | Gary M Pitts | Family Medicine | 2300 Dubois Dr, Warsaw, IN 46580-3213 | 2006-02-28 |
| 1295705622 | Community Health Centers of Southeastern Iowa Inc | Family Medicine | 345 Polk St, Warsaw, IL 62379-1033 | 2006-01-26 |
| 1972591030 | Theodore J Beltz | Family Medicine | 1765 Commercial St, Warsaw, MO 65355-3096 | 2005-10-12 |
| Find all providers in WARSAW | ||||
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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.