TIM LONG M.D., PSC
NPI 1417057902
Clinic/Center - Primary Care in Bowling Green, KY
About Tim Long M.d., Psc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
TIM LONG M.D., PSC (NPI 1417057902) is a healthcare organization registered as a primary care in Bowling Green, Kentucky and active in the NPI registry since September 2006. The organization holds a CLIA Waiver certificate valid through March 7, 2028 and lists Timothy R. Long, President, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 2
Other Identifiers 4
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Tim Long M.d., Psc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
4Medicare enrollment records show 4 clinicians reassign Medicare billing to Tim Long M.D., Psc, which bills Medicare for the services they deliver. Of these, 4 practice at this address. They are listed nearest first.
Clinicians, nearest first (4)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 18D1000308
Tim Long MD Psc · Bowling Green, KYFrequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Tim Long M.D., Psc's NPI number?
The NPI number for Tim Long M.D., Psc is 1417057902. It was assigned to this organization in the NPPES registry on September 24, 2006.
Where is Tim Long M.D., Psc located?
Tim Long M.D., Psc is located at 1320 Andrea St, Bowling Green, KY 42104. The listed phone number is (270) 746-5455.
What is Tim Long M.D., Psc's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.
Is Tim Long M.D., Psc enrolled in Medicare?
Yes. Tim Long M.D., Psc is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Tim Long M.D., Psc?
According to the CMS Revalidation Reassignment List (October 2026 release), 4 clinicians in 2 Medicare specialties reassign their Medicare billing to Tim Long M.D., Psc. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (3) and Family Practice (1). Of these, 4 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Tim Long M.D., Psc hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 18D1000308) is associated with this NPI, valid through March 7, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Tim Long M.D., Psc accept?
Health plans from Anthem Blue Cross and Blue Shield list Tim Long M.D., Psc as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Tim Long M.D., Psc was last updated on March 6, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Tim Long M.d., Psc · NPI 1417057902
Primary Care organization in Bowling Green, Kentucky. Organization record, active in the CMS NPPES registry since September 24, 2006.
## Identity
- **NPI:** 1417057902 (Entity type: Organization)
- **Enumerated:** September 24, 2006
- **Primary specialty:** Clinic/Center - Primary Care · taxonomy 261QP2300X
- **Organization subpart:** No
- **Authorized official:** Timothy Long, PRESIDENT
## Practice location
- **Address:** 1320 ANDREA ST, Bowling Green, KY 42104-3334
- **Phone:** (270) 746-5455 · **Fax:** (270) 746-5688
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 4 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (3), Family Practice (1); 4 practice at this address · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** March 6, 2008
- **Other identifiers:** Other 000000216368; Medicare PIN 7123; Medicaid 65936585 (KY); and 1 more
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1417057902) · Data from the CMS NPPES public registry.