Tish Kennedy Long, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2305204042 Issued in VA

Practice address

984B Laskin Rd
Virginia Beach, VA 23451-3905

Phone

(757) 395-6900

Fax

(757) 425-7180

NPI assigned

Oct 12, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Tish Kennedy Long Former name

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sentara Therapy Solutions LLCGroup PAC ID 8325370380, 33 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

21.85 of 100Reported as individual

Quality

0

Improvement activities

0

Cost

72.82

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Sentara Therapy Solutions, LLC

  • Physical Therapist
  • Norfolk, VA
  • NPI 1316590789
  Medicare reassignment Care Compare group NPD
• Tidewater Physical Therapy, LLC

  • Physical Therapist
  • Glen Allen, VA
  • NPI 1457389595
  Medicare reassignment NPD
• Sentara Therapy Solutions, LLC

  • Physical Therapist
  • Virginia Beach, VA
  • NPI 1972137032
  NPD
• Tidewater Physical Therapy, LLC

  • Physical Therapist
  • Roanoke, VA
  • NPI 1437664356
  NPD

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

{
    "created_epoch": "1507766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617753600000",
    "number": "1013428333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "984B LASKIN RD",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234513905",
            "telephone_number": "757-395-6970",
            "fax_number": "757-425-7180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "984B LASKIN RD",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234513905",
            "telephone_number": "757-395-6900",
            "fax_number": "757-425-7180"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4624 Pembroke Blvd Ste 101",
            "address_purpose": "LOCATION",
            "city": "Virginia Beach",
            "state": "VA",
            "postal_code": "234556450",
            "country_code": "US",
            "telephone_number": "757-460-3363",
            "fax_number": "757-460-1809",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6161 Kempsville Cir",
            "address_purpose": "LOCATION",
            "city": "Norfolk",
            "state": "VA",
            "postal_code": "235026450",
            "country_code": "US",
            "telephone_number": "757-965-4890",
            "fax_number": "757-965-4893",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LONG",
        "first_name": "TISH",
        "middle_name": "KENNEDY",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-12",
        "last_updated": "2021-04-07",
        "certification_date": "2021-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305204042",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TISH",
            "last_name": "LONG",
            "middle_name": "KENNEDY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Cahrin Long-Ivey
• Monita Long-Smith, LPTA
• Jacob Long, DPT
• Kyla Jade Long, MS
• Lovelyn Long, QBHP
• Carolina Bacani Longa, MD
• Longevity Institute of Virginia
• Nancy Sue Longfors, MD
• Bruce Irving Longman, DDS
• Heather C Longoria

• Physical Therapist in Virginia Beach, VA
• Providers in Virginia Beach, VA by specialty
• Physical Therapist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.