Kyle David Long, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0110006758 Issued in VA

Practice address

825 Fairfax Ave Unit 310
Norfolk, VA 23507-1914

Phone

(757) 238-4497

NPI assigned

Mar 28, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in VA, DC, FL, NC4 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 4

Specialty

Physician Assistant

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Florida Trauma Services LLCGroup PAC ID 3971985938, 92 clinicians

Mission Health Community Multispecialty Providers LLCGroup PAC ID 9537468574, 601 clinicians

Urgent Specialty Associates PLLCGroup PAC ID 7618235995, 56 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Memorial Mission Hospital and Asheville Surgery Ce Hospital, Asheville, NC, CCN 340002
• CJW Medical Center Hospital, Richmond, VA, CCN 490112

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Networks

• Optimum HealthCare HMO Network
• Freedom Health HMO Network

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.

• Florida Trauma Services, LLC

  • Trauma Surgery Physician
  • Fort Walton Beach, FL
  • NPI 1477296952

  Multi-Specialty

  Medicare reassignment Care Compare group NPD
• Urgent Specialty Associates PLLC

  • Surgery Physician
  • Richmond, VA
  • NPI 1487164604

  DC

  Medicare reassignment Care Compare group
• Mission Health Community Multispecialty Providers, LLC

  • Anesthesiology Physician
  • Asheville, NC
  • NPI 1457719130
  Medicare reassignment Care Compare group
• Velocity Urgent Care, LLC

  • Urgent Care Clinic/Center
  • Williamsburg, VA
  • NPI 1205350584

  Multi-Specialty

  Medicare reassignment NPD
• SMH Physician Services Inc

  • Internal Medicine Physician
  • Sarasota, FL
  • NPI 1346295292

  Multi-Specialty

  Medicare reassignment NPD
• Mission Community Anesthesiology Specialists LLC

  • Certified Respiratory Therapist
  • Asheville, NC
  • NPI 1528538766

  Multi-Specialty

  NPD
• Mission Community Anesthesiology Specialists LLC

  • Ph.D. Medical Genetics
  • Asheville, NC
  • NPI 1568932879

  Multi-Specialty

  NPD
• Mission Community Anesthesiology Specialists LLC

  • Clinical Social Worker
  • Asheville, NC
  • NPI 1235609538

  Multi-Specialty

  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Chippenham & Johnston-Willis Hospitals Inc

  • General Acute Care Hospital
  • Richmond, VA
  • NPI 1598708513
  Care Compare affiliation
• MH Mission Hospital, LLLP

  • General Acute Care Hospital
  • Asheville, NC
  • NPI 1962987677
  Care Compare affiliation

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

{
    "created_epoch": "1553731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655164800000",
    "number": "1144781576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4701 LAKE SHORE DR",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233211383",
            "telephone_number": "757-803-4806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 FAIRFAX AVE UNIT 310",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235071914",
            "telephone_number": "757-238-4497"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONG",
        "first_name": "KYLE",
        "middle_name": "DAVID",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-03-28",
        "last_updated": "2022-06-14",
        "certification_date": "2022-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110006768",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110006758",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deborah J London, RPH MBA
• Long Journey Counseling, LLC
• Long Term Care of Tidewater PC
• Darelle Yvette Long
• Genevieve Long, LCSW
• Mark A D Long, ED.D.
• Paige Long
• Sherry R Longshore
• Noah Longton
• Zena Coreen Longvall, PA-C

• Physician Assistant in Norfolk, VA
• Providers in Norfolk, VA by specialty
• Physician Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.