Kyle M Longo, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2132 Issued in TN

Practice address

2269 Wilma Rudolph Blvd Ste 107
Clarksville, TN 37040-8416

Phone

(931) 905-1720

Fax

(931) 905-1721

NPI assigned

Oct 2, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/15045/brand/1/csg/1/fhir/r4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Pain Institute, LTD

  • Durable Medical Equipment & Medical Supplies
  • Swansea, IL
  • NPI 1609142918
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317254400000",
    "number": "1003909128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2269 WILMA RUDOLPH BLVD STE 107",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370408416",
            "telephone_number": "931-905-1720",
            "fax_number": "931-905-1721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2269 WILMA RUDOLPH BLVD STE 107",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370408416",
            "telephone_number": "931-905-1720",
            "fax_number": "931-905-1721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONGO",
        "first_name": "KYLE",
        "middle_name": "M",
        "name_prefix": "Mr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2011-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TN",
            "license": "2132",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER#",
            "identifier": "4218740",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• McKenna Long
• Melissa Long
• Tara Nicole Long, PT
• Timothy Longawa
• Gina Longo, MSN FNP
• Joyse Lopata
• Angelica Elizabeth Lopez, DPT
• Elizabeth Lopez, B.S.
• Jasmine Lopez, BEHAVIOR TECHNICIAN
• Natalie Lopez

• Chiropractor in Clarksville, TN
• Providers in Clarksville, TN by specialty
• Chiropractor in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.