DR. JACK A LONG (NPI# 1184792129) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184792129 |
| Entity Type | Individual |
| Full Name | DR. JACK A LONG |
| Credential | D.C. |
| Practice Address |
2893 E Green Canyon Dr Meridian ID 83642-9105 |
| Practice Telephone | 2088506511 |
| Practice Fax Number | 2088883882 |
| Mailing Telephone | 2088506511 |
| Mailing Fax Number | 2088883882 |
| Enumeration Date | 2006-11-30 |
| Last Update Date | 2007-07-09 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | CHIA-352 | ID | Chiropractic Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | 0025046 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447296629 | Jack Martin Long | Social Worker | 720c Maiden Choice Ln, Catonsville, MD 21228-5940 | 2006-06-22 |
| 1366480949 | Jack E Long | Internal Medicine | 100 E 33rd St Ste 100, Vancouver, WA 98663-2776 | 2006-06-03 |
| 1861918534 | Jack Long | Physical Therapist | 425 Waverley Oaks Rd, Waltham, MA 02452-8448 | 2017-08-15 |
| 1376534917 | Jack Calhoun Long | Specialist | 1900 Scenic Dr, Suite 3318, Georgetown, TX 78626-7724 | 2005-11-02 |
| Street Address |
2893 E GREEN CANYON DR |
| City | MERIDIAN |
| State | ID |
| Zip Code | 83642-9105 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174145684 | Ikdo South Meridian LLC | Dentist | 3839 E Amity Rd, Meridian, ID 83642 | 2020-05-07 |
| 1073133328 | Prescription Pad LLC | Pharmacy | 885 S Vanguard Way, Meridian, ID 83642 | 2020-04-16 |
| 1609412683 | Meridian Advanced Psychiatry, LLC | Psychiatry & Neurology | 1672 S Woodsage Ave., Meridan, ID 83642 | 2019-11-25 |
| 1194378927 | Sergey Tsema | Occupational Therapist | 1259 E Pisa St, Meridian, ID 83642 | 2019-07-21 |
| 1003478629 | Chris R Jackson | Dentist | Isu Family Dentistry, 1311 E Central Dr, Meridian, ID 83642 | 2019-07-03 |
| 1285293118 | Morgan Family Medicine | Nurse Practitioner | 1660 S Woodsage Avenue, Meridian, ID 83642 | 2019-06-13 |
| 1033772793 | Nugen Healthcare, Pllc | Registered Nurse | 2177 S Spoonbill Ave, Meridian, ID 83642 | 2019-04-18 |
| 1811471790 | Courtney Crossland | Physician Assistant | 4949 S Hillsdale Ave., Meridian, ID 83642 | 2018-09-18 |
| 1841771938 | Katelyn Perry | Counselor | 2068 S. Eagle Rd., Meridian, ID 83642 | 2018-08-27 |
| 1114406204 | Gem Prep: Meridian LLC | Case Management | 2750 E.gala Ct., Meridian, ID 83642 | 2018-08-09 |
| Find all providers in zip 83642 | ||||
| Taxonomy Code | 111N00000X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568093136 | Allcorp LLC | Chiropractor | 1948 S Eagle Rd, Meridian, ID 83642-2452 | 2020-01-31 |
| 1083274260 | Chiropractic Billing Center | Chiropractor | 520 S Meridian Rd Ste 60, Meridian, ID 83642-4533 | 2019-06-19 |
| 1891270229 | Slonaker Enterprises, LLC | Chiropractor | 3329 W Cherry Ln, Meridian, ID 83642-1119 | 2018-10-02 |
| 1316425960 | Chad William Queen | Chiropractor | 3088 W Tenuta St, Meridian, ID 83646-3216 | 2018-08-04 |
| 1841707007 | William Clayton Ramos | Chiropractor | 1735 W Franklin Rd, Meridian, ID 83642-8330 | 2018-01-09 |
| 1811402431 | Evergreen Wellness Partners, LLC | Chiropractor | 1710 W Cherry Ln, Meridian, ID 83642-1340 | 2017-12-05 |
| 1235641374 | Raymond Drew Flack | Chiropractor | 3405 E Overland Rd Ste 110, Meridian, ID 83642-5111 | 2017-10-30 |
| 1598281321 | White Brothers Investments | Chiropractor | 1520 E Heritage Park St Ste 150, Meridian, ID 83646-5886 | 2017-08-14 |
| 1306368188 | Hailey Haugen | Chiropractor | 3085 E Magic View Dr # 180, Meridian, ID 83642-3757 | 2017-07-12 |
| 1457885170 | Mobile Chiropractic and Wellness Pllc | Chiropractor | 3784 N Chocaya Pl, Meridian, ID 83646-6075 | 2017-04-19 |
| Find all providers in MERIDIAN | ||||
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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.