DR. GINA LONG (NPI# 1235107798) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235107798 |
| Entity Type | Individual |
| Full Name | DR. GINA LONG |
| Credential | M.D. |
| Practice Address |
4940 W Clark Rd Suite 100 Ypsilanti MI 48197-0860 |
| Mailing Address |
2100 Commonwealth Blvd Suite 202 Ann Arbor MI 48105-1593 |
| Practice Telephone | 7344340477 |
| Practice Fax Number | 7344346240 |
| Enumeration Date | 2006-03-10 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207V00000X | Obstetrics & Gynecology | 4301066331 | MI | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811446479 | Gina Long | Licensed Practical Nurse | 4300 Sw 13th St, Gainesville, FL 32608-4006 | 2016-09-23 |
| Street Address |
4940 W CLARK RD SUITE 100 |
| City | YPSILANTI |
| State | MI |
| Zip Code | 48197-0860 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871583286 | Jennifer Ann Lemmen | Chiropractor | 4940 W Clark Rd, Suite 101, Ypsilanti, MI 48197-0860 | 2005-10-26 |
| 1659647717 | Shahbaz Shahid Nisar | Family Medicine | 4940 W Clark Rd, Suite 100, Ypsilanti, MI 48197-0860 | 2012-03-22 |
| 1346401601 | Shannon Kay Kusiak | Family Medicine | 4940 W Clark Rd, Ste 100, Ypsilanti, MI 48197-0860 | 2008-06-19 |
| 1588822746 | Arbor Park Chiropractic Wellness Center | Chiropractor | 4940 W Clark Rd, Suite 101, Ypsilanti, MI 48197-0860 | 2008-05-23 |
| 1396950044 | Melissa Andrzejak Goedtel | Obstetrics & Gynecology | 4940 W Clark Rd, Ypsilanti, MI 48197-0860 | 2007-05-14 |
| 1952423881 | Cameron M Mouro | Obstetrics & Gynecology | 4940 W Clark Rd, Ste 100, Ypsilanti, MI 48197-0860 | 2007-04-04 |
| 1699822742 | Iha Health Services Corporation | Family Medicine | 4940 W Clark Rd, Ste 100, Ypsilanti, MI 48197-0860 | 2007-01-04 |
| 1932299104 | Arbor Park Family Chiropractic PC | Chiropractor | 4940 W Clark Rd, Suite 101, Ypsilanti, MI 48197-0860 | 2006-10-16 |
| 1649373093 | Vaishali Katial | Family Medicine | 4940 W Clark Rd, Ste 100, Ypsilanti, MI 48197-0860 | 2006-09-07 |
| 1700990405 | Bryan Popp | Obstetrics & Gynecology | 4940 W Clark Rd, Suite 100, Ypsilanti, MI 48197-0860 | 2006-08-18 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700423092 | Devika Dibya Choudhuri | Counselor | 135 Porter West Circle Drive, Ypsilanti, MI 48197 | 2019-12-05 |
| 1770128837 | Brian Lee Shue | Registered Nurse | 6277 Maplehurst Dr, Ypsilanti, MI 48197 | 2019-11-13 |
| 1639721566 | Darlene E Bellers | 845 W. Circle Dr, Suite 160, Ypsilanti, MI 48197 | 2019-07-11 | |
| 1073165874 | Eastern Michigan University | Dietitian, Registered | Suite 160 Rackham, Ypsilanti, MI 48197 | 2019-07-11 |
| 1447815469 | Rainbow Rehabilitation Centers, Inc. | Community Based Residential Treatment Facility, Mental Illness | 6200 Textile Rd, Ypsilanti, MI 48197 | 2019-05-06 |
| 1417416298 | Justin Brewer | Student in an Organized Health Care Education/Training Program | 5333 Mcauley Drive Suite 2115, Ypsilanti, MI 48197 | 2019-03-19 |
| 1124519780 | Great Lakes Mindfulness LLC | Community/Behavioral Health | 4007 Carpenter Rd # 280, Ypsilanti, MI 48197 | 2018-05-19 |
| 1841799715 | Bedside Angel's Home Care, LLC | Home Health | 2032 S. Congress Street, Ypsilanti, MI 48197 | 2018-02-06 |
| 1891211777 | Brandon James Kukal | Specialist/Technologist | 799 N Hewitt, Ypslinati, MI 48197 | 2017-08-22 |
| 1669908737 | Michael Bekkerman | Student in an Organized Health Care Education/Training Program | 5303 Elliot Drive, Cancer Center, Ypsilanti, MI 48197 | 2017-05-10 |
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| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396805834 | Pooja Mittal Green | Obstetrics & Gynecology | 4918 W Clark Rd Ste 104, Ypsilanti, MI 48197-1142 | 2006-12-12 |
| 1841368081 | Robert Stager | Obstetrics & Gynecology | 5333 Mcauley Dr Rm 2108, Ypsilanti, MI 48197-1096 | 2006-12-04 |
| 1962408161 | Fayek Nicholas Shamma | Obstetrics & Gynecology | 3145 W Clark Rd, Ste 301, Ypsilanti, MI 48197-1120 | 2005-06-22 |
| 1184070690 | Laura Marie Ruch | Obstetrics & Gynecology | 5333 Mcauley Drive, Suite 2110, Ypsilanti, MI 48197-8633 | 2016-05-13 |
| 1437533064 | Iha Health Services Corporation | Obstetrics & Gynecology | 5333 Mcauley Dr, Ste 2110, Ypsilanti, MI 48197-1014 | 2015-07-14 |
| 1710374376 | Sara Muszynski | Obstetrics & Gynecology | 4936 W Clark Rd Ste 100, Ypsilanti, MI 48197-0861 | 2015-04-22 |
| 1124425285 | Iha Health Services Corporation | Obstetrics & Gynecology | 5333 Mcauley Dr, Suite 2110, Ypsilanti, MI 48197-1014 | 2014-12-04 |
| 1033524962 | Katharine Micallef | Obstetrics & Gynecology | 5333 Mcauley Dr Rm 2110, Ypsilanti, MI 48197-1097 | 2014-06-30 |
| 1740609122 | Jade Burch | Obstetrics & Gynecology | 5333 Mcauley Dr, Suite 2110, Ypsilanti, MI 48197-1014 | 2014-04-14 |
| 1780002568 | Caitlin Callahan Parker | Obstetrics & Gynecology | 4936 W Clark Rd Ste 100, Ypsilanti, MI 48197-0861 | 2014-03-31 |
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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.