Kiana Long, D.O.

Individual provider Active NPI Family Medicine Physician · Trenton, MO

NPI 1285807362 · NPPES record last updated Oct 23, 2019

Key facts

NPI
1285807362
Entity type
Individual (NPI type 1)
Primary specialty
Family Medicine Physician 207Q00000X
License
20100000750 (MO)
Practice address
191 Iowa Blvd
Wright Memorial Hospital
Trenton, MO 64683-8343
Phone
(660) 358-5700
NPI assigned
Apr 9, 2008
Sex
Female
Sole proprietor
No

Organizations & group practices 5

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.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20100603000019 MO Practitioner - Family Practice
Practitioner - Emergency Medicine
5496884397 Reassigns benefits to 3 organizations

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
20100000750MOMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Macon County Samaritan Hospital Current
since Mar 1, 2016
Accepting new patients
Cameron Regional Medical Center Inc Current
since Jan 15, 2018
Accepting new patients
General John J Pershing Memorial Hospital Association Current
since May 29, 2015
Accepting new patients
Cameron Regional Medical Center, Inc. Current
since Jan 15, 2018
Accepting new patients
General John J Pershing Memorial Hospital Association Current
since May 29, 2015
Accepting new patients

Locations

130 E Lockling St
Brookfield, MO 64628
Phone (660) 258-1050

1600 E Evergreen St
Cameron, MO 64429
Phone (816) 632-2101

1205 N Missouri St
Macon, MO 63552
Phone (660) 385-3151

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 20100000750 MO Yes

Addresses

Primary practice location

191 Iowa Blvd
Wright Memorial Hospital
Trenton, MO 64683-8343

Mailing address

1109 SE Meridian Dr
Lees Summit, MO 64081-3149
Phone (925) 354-6074

Other practice location 1

705 N College St
Albany, MO 64402-1433
Phone (660) 726-3941

Other practice location 2

705 N College St
Albany, MO 64402-1433
Phone (660) 726-3941

Other providers in Trenton, MO

All providers in Trenton, MO · Family Medicine Physician in Missouri

Sources for this page

Verify at the official NPI Registry.