TIM LONG M.D., PSC
NPI 1417057902
Clinic/Center - Primary Care in Bowling Green, KY

Active since September 24, 2006CLIA 18D1000308 · Waiver
1320 ANDREA ST, BOWLING GREEN, KY 42104(270) 746-5455(270) 746-5688 Get Directions Write a Review

NPPES record last updated: March 6, 2008. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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

NPI1417057902
Entity TypeOrganization
Primary Taxonomy261QP2300X
Legal Business NameTIM LONG M.D., PSC
Location Address1320 ANDREA STBowling Green, KY 42104-3334
Mailing Address1320 Andrea StBowling Green, KY 42104-3334 · (270) 746-5455 · Fax (270) 746-5688
Fax(270) 746-5688
Organization SubpartNo
Authorized OfficialTimothy R. LongPresident · (270) 746-5455
Enumeration DateSeptember 24, 2006
Last NPPES UpdateMarch 6, 2008
NPI 1417057902 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyClinic/Center · Primary CareAmbulatory Health Care Facilities
Taxonomy Code261QP2300X
Also ListedClinic/CenterTaxonomy 261Q00000X
1320 ANDREA ST, Bowling Green, KY 42104

Other Identifiers 4

Other000000216368Bc/bs
Medicare PIN7123
Medicaid65936585KY
OtherDA8524Medicare Railroad

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, KY
Active · expires Mar 7, 2028
CLIA Number18D1000308
Laboratory TypePhysician Office
Certificate Effective DateMarch 8, 2026
Certificate Expiration DateMarch 7, 2028
Laboratory DirectorTim Long
Laboratory Phone(270) 746-5455
Laboratory LocationTim Long MD Psc1320 Andrea Street, Bowling Green, KY 42104
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Nurse Practitioner
1320 ANDREA ST
BOWLING GREEN, KY 42104
Nurse Practitioner (Family)
1320 ANDREA ST
BOWLING GREEN, KY 42104
Nurse Practitioner (Family)
1320 ANDREA ST
BOWLING GREEN, KY 42104
Nurse Practitioner (Family)
1320 ANDREA ST
BOWLING GREEN, KY 42104
Family Medicine
1320 ANDREA ST
BOWLING GREEN, KY 42104

Frequently 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.

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.

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.