Kathleen Therese Long, AU.D.

Primary specialty

AudiologistTaxonomy code 231H00000X

License

81504 Issued in TX

Practice address

4859 Williams Dr Ste 109
Georgetown, TX 78633-2304

Phone

(512) 357-8000

NPI assigned

Jun 13, 2023

Sex

Female

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 TX

Enrollment records 1

Specialty

Qualified Audiologist

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Wondearfully Audacious, LLCGroup PAC ID 4385078385, 4 clinicians

Practice addresses (Care Compare)

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.

• Wondearfully Audacious, LLC

  • Hearing and Speech Clinic/Center
  • Cedar Park, TX
  • NPI 1235774704

  Audiologist-Hearing Aid Fitter

  Medicare reassignment Care Compare group NPD
• DCLC Enterprises, LLC

  • Audiologist
  • Cedar Park, TX
  • NPI 1427191014
  NPD

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

{
    "created_epoch": "1686614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726185600000",
    "number": "1194409821",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1603 MEDICAL PKWY STE 200",
            "city": "CEDAR PARK",
            "state": "TX",
            "postal_code": "786137904",
            "telephone_number": "512-260-2665",
            "fax_number": "512-260-2668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4859 WILLIAMS DR STE 109",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786332304",
            "telephone_number": "512-357-8000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "351 Exchange Blvd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Hutto",
            "state": "TX",
            "postal_code": "786345846",
            "country_code": "US",
            "telephone_number": "737-304-7573",
            "fax_number": "737-304-7574",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LONG",
        "first_name": "KATHLEEN",
        "middle_name": "THERESE",
        "name_prefix": "Dr.",
        "credential": "AU.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-13",
        "last_updated": "2024-09-13",
        "certification_date": "2024-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "TX",
            "license": "81504",
            "primary": true
        },
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "TX",
            "license": "81504",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lone Star Circle of Care
• Lone Star Circle of Care
• Lone Star Vein Institute PLLC
• Jack Calhoun Long, MD
• Karen Marie Long, CFNP
• Longhorn Senior Care, LLC
• David W. Loper, D.C.
• Rafael Lopez, D.C.
• Lori L. Palazzo M.D. LLC
• Lotus Dental of Texas

• Audiologist in Georgetown, TX
• Providers in Georgetown, TX by specialty
• Audiologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2024; 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.