Jennica Long

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601012849 Issued in MI

Practice address

818 W King St Ste 101
Owosso, MI 48867-2159

Phone

(989) 725-8171

NPI assigned

Oct 29, 2024

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

Medicare fee-for-service enrollment

Enrolled in MI

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 1

Specialty

Physician Assistant

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Memorial HospitalGroup PAC ID 8527976497, 210 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Memorial Healthcare Hospital, Owosso, MI, CCN 230121

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jlong@memorialhealthcare.midirect.net

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.

• Memorial Hospital

  • General Practice Physician
  • Owosso, MI
  • NPI 1235160532
  Medicare reassignment Care Compare group
• Memorial Hospital

  • General Practice Physician
  • Flushing, MI
  • NPI 1144428202

  Physician Assistant

  NPD
• Memorial Hospital

  • Anesthesiology Physician
  • Owosso, MI
  • NPI 1659527737
  NPD
• Memorial Hospital

  • General Practice Physician
  • Owosso, MI
  • NPI 1316008006

  Physician Assistant

  NPD (past)
• Memorial Hospital

  • Home Health Agency
  • Owosso, MI
  • NPI 1952498610
  NPD (past)

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

• Memorial Hospital

  • General Acute Care Hospital
  • Owosso, MI
  • NPI 1063414233
  Care Compare affiliation

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

{
    "created_epoch": "1730160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730160000000",
    "number": "1235951328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "818 W KING ST STE 101",
            "city": "OWOSSO",
            "state": "MI",
            "postal_code": "488672159",
            "telephone_number": "989-725-8171",
            "fax_number": "989-723-1257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "818 W KING ST STE 101",
            "city": "OWOSSO",
            "state": "MI",
            "postal_code": "488672159",
            "telephone_number": "989-725-8171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONG",
        "first_name": "JENNICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-29",
        "last_updated": "2024-10-29",
        "certification_date": "2024-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601012849",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sonja Rebecca Linke
• Serra Lipa
• Kendra Littlefield, RMA
• Living Well Professional Services LLC
• Payton Lockhart
• Stephanie Lopez
• Renee Louch
• Gregory Love, LBSW
• Selena June Lovejoy, LLPC
• Alex Lovelace

• Physician Assistant in Owosso, MI
• Providers in Owosso, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2024; 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.