MR. CARL EDWARD LONG JR. (NPI# 1871564815) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871564815 |
| Entity Type | Individual |
| Full Name | MR. CARL EDWARD LONG JR. |
| Credential | PA-C |
| Practice Address |
2080 Child St Jacksonville FL 32214-5005 |
| Mailing Address |
1012 Drake Feather Dr Orange Park FL 32065-5209 |
| Practice Telephone | 9125734267 |
| Mailing Telephone | 9046257395 |
| Enumeration Date | 2006-01-28 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
1053572 | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306951215 | Carl Thomas Long IIi | Internal Medicine | 4708 Alliance Blvd Ste 300, Baylor Medical Plaza 1, Plano, TX 75093-5339 | 2006-08-20 |
| Street Address |
2080 CHILD ST |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32214-5005 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205836202 | Juan Pedro Rivera | Psychiatry & Neurology | 2080 Child St, Jacksonville, FL 32214-5005 | 2005-08-01 |
| 1477169662 | Bobby Joe Neal Kimbro | General Practice | 2080 Child St, Jacksonville, FL 32214-5005 | 2020-09-22 |
| 1659986529 | Henry Lee Simmons Jr. | Pharmacist | 2080 Child St, Jacksonville, FL 32214-5005 | 2020-09-09 |
| 1982228441 | Chantel Charais | Nurse Practitioner | 2080 Child St, Jacksonville, FL 32214-5005 | 2020-06-01 |
| 1598388936 | Joseph Royer | Student in an Organized Health Care Education/Training Program | 2080 Child St, Jacksonville, FL 32214-5005 | 2020-05-20 |
| 1780206359 | Devin Alan Rickard | Student in an Organized Health Care Education/Training Program | 2080 Child St, Jacksonville, FL 32214-5005 | 2020-05-17 |
| 1881216307 | Adam Dillon Ratcliff | Student in an Organized Health Care Education/Training Program | 2080 Child St, Jacksonville, FL 32214-5005 | 2020-05-07 |
| 1619598588 | Sarah Chilson | Nurse Practitioner | 2080 Child St, Jacksonville, FL 32214-5005 | 2020-05-02 |
| 1942820360 | Gregory Hay | Student in an Organized Health Care Education/Training Program | 2080 Child St, Jacksonville, FL 32214-5005 | 2020-04-27 |
| 1568083996 | Aaron Hancock | Student in an Organized Health Care Education/Training Program | 2080 Child St, Jacksonville, FL 32214-5005 | 2020-04-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699255653 | Natalia Rosa Terreros | Nurse Practitioner | 2080 Childs Street, Jacksonville, FL 32214 | 2018-08-20 |
| 1841586120 | Travis Christopher Allemang | Urology | 2080 Child St Dept 5000, Jacksonville, FL 32214 | 2011-06-24 |
| 1730169202 | Quinn Steven Bastian | Psychologist | 2080 Child Street, Mental Health Dept - Bldg 2034 / Nh Jax, Jacksonville, FL 32214 | 2006-01-19 |
| 1760753982 | Jennifer Marie Brooks | Registered Nurse | 2080 Child Street, Jacksonville, FL 32214 | 2012-01-19 |
| 1114298338 | Louis Humberto Grass IIi | Registered Nurse | 2080 Child Street, Anesthesia Dept, Jacksonville, FL 32214 | 2012-01-19 |
| 1851685713 | John Manning Lydon | Obstetrics & Gynecology | 2080 Child Street, Jacksonville, FL 32214 | 2011-06-07 |
| 1093865693 | Elisha Yvette Hansack | Pharmacist | 2080 Child Street, Jacksonville, FL 32214 | 2007-01-12 |
| 1073544466 | Ren-chang Liu | Radiology | 2080 Child Street, Jacksonville, FL 32214 | 2006-07-05 |
| 1598795742 | Beverly B. Nysewander | Nurse Practitioner | 2080 Child Street, Internal Medicine, Jacksonville, FL 32214 | 2006-07-04 |
| 1841823606 | Christine Due Higgins | Midwife | Naval Hospital Jacksonville 2089 Child St, Jacksonville, FL 32214-0001 | 2020-02-19 |
| Find all providers in zip 32214 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851919526 | Kyra Panni | Physician Assistant | 3857 Hartwood Ln, Jacksonville, FL 32216-1486 | 2020-07-09 |
| 1467935213 | Alexis Almonte | Physician Assistant | 655 W 8th St # C-3, Jacksonville, FL 32209-6511 | 2018-09-07 |
| 1053851535 | Luciana Oran | Physician Assistant | 4849 Florida Club Cir Apt 3104, Jacksonville, FL 32216-1089 | 2017-03-02 |
| 1699217463 | Ashley C Moyer | Physician Assistant | 5742 Booth Rd Ste A, Jacksonville, FL 32207-5982 | 2016-11-10 |
| 1437600889 | Lindsay Elizabeth Murrell | Physician Assistant | 14540 Old Saint Augustine Rd Ste 2599, Jacksonville, FL 32258-7420 | 2016-10-20 |
| 1992178719 | Sonila Musta-kina | Physician Assistant | 1633 Race Track Rd Ste 101, Jacksonville, FL 32259-3237 | 2015-11-02 |
| 1922409580 | Lindsey Beth Hollingsworth | Physician Assistant | 841 Prudential Dr Ste 1900, Jacksonville, FL 32207-8373 | 2014-09-12 |
| 1487905220 | Krystin Michelle Greene | Physician Assistant | 4085 University Blvd S Ste 3, Jacksonville, FL 32216-4362 | 2012-09-19 |
| 1790034296 | Gary Robertson | Physician Assistant | 12964 Winthrop Cove Dr, Jacksonville, FL 32224-7503 | 2012-08-30 |
| 1366711905 | Jeremiah Taejong Oh | Physician Assistant | 3d Battalion, 8th Marines Psc Box 20104, Camp Lejeune, Jacksonville, NC 28542-0104 | 2011-12-28 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32214 |
Please comment or provide details below to improve the information on MR. CARL EDWARD LONG JR..
| 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.