Kathryn Gray Long, DPT

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

2305211480 Issued in VA

Practice address

350 New Fidelity CT
Garner, NC 27529-2665

Phone

(919) 258-2714

Fax

(410) 648-4878

NPI assigned

Sep 11, 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 identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Networks

• Optimum HealthCare HMO Network
• Freedom Health HMO Network

Interoperability endpoints

• Direct secure messaging: kathryn.long.p1@direct.winc-ortho.nextgenshare.com

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.

• Potentia Therapeutics, LLC

  • Physical Therapist
  • Tampa, FL
  • NPI 1063910982
  Medicare reassignment NPD
• Highlander Family Medicine PLLC

  • Family Medicine Physician
  • Woodstock, VA
  • NPI 1326199910
  NPD (past)

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

{
    "created_epoch": "1505088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541721600000",
    "number": "1194244277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1195 HISEY AVE",
            "city": "WOODSTOCK",
            "state": "VA",
            "postal_code": "226642097",
            "telephone_number": "540-459-7772",
            "fax_number": "540-459-7782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 NEW FIDELITY CT",
            "city": "GARNER",
            "state": "NC",
            "postal_code": "275292665",
            "telephone_number": "919-258-2714",
            "fax_number": "410-648-4878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONG",
        "first_name": "KATHRYN",
        "middle_name": "GRAY",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-11",
        "last_updated": "2018-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "VA",
            "license": "2305211480",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMONWEALTH OF VIRGINIA BOARD OF PHYSICAL THERAPY LICENSE",
            "identifier": "2305211480",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hannah Little
• Living Well Behavioral Health Inc
• Tammie Locklear, CCC-SLP
• Alexis Long
• Carlin Long, PT, DPT
• Michael Kenneth Lorentsen, MD
• Love Yours Home Care LLC
• Qin Ching Lu, R.PH
• Lucia in Homecare Agency Inc
• Michelle M Lutchman, MHA, MSW, LCSW, CCM

• Physical Medicine & Rehabilitation Physician in Garner, NC
• Providers in Garner, NC by specialty
• Physical Medicine & Rehabilitation Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2018; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.