Active NPI
Kelly Ann Long
- Physician Assistant
- Brookhaven, GA
National Provider Identifier
1306715503
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- Practice address
- 1284 Hampton Hall Dr NE
Brookhaven, GA 30319-1962 - Phone
- (404) 263-3378
- NPI assigned
- Nov 4, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | GA | Primary |
Addresses
Primary practice location
1284 Hampton Hall Dr NE
Brookhaven, GA 30319-1962
Mailing address
1284 Hampton Hall Dr NE
Brookhaven, GA 30319-1962
Phone (404) 263-3378
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1762214400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1762214400000",
"number": "1306715503",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1284 HAMPTON HALL DR NE",
"city": "BROOKHAVEN",
"state": "GA",
"postal_code": "303191962",
"telephone_number": "404-263-3378"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1284 HAMPTON HALL DR NE",
"city": "BROOKHAVEN",
"state": "GA",
"postal_code": "303191962",
"telephone_number": "404-263-3378"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LONG",
"first_name": "KELLY",
"middle_name": "ANN",
"name_prefix": "Ms.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-11-04",
"last_updated": "2025-11-04",
"certification_date": "2025-11-04",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "GA",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brookhaven, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.