Individual provider Active NPI

Kathryn Long

  • Occupational Therapist
  • Plymouth, MI
National Provider Identifier
1336869460
Registry record updated Aug 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Practice address
44670 Ann Arbor Rd W Ste 130
Plymouth, MI 48170-4085
Phone
(734) 201-1542
NPI assigned
Aug 30, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X Primary

Addresses

Primary practice location

44670 Ann Arbor Rd W Ste 130
Plymouth, MI 48170-4085

Mailing address

44670 Ann Arbor Rd W Ste 130
Plymouth, MI 48170-4085
Phone (734) 201-1542

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220923002054 MI Practitioner - Occupational Therapist in Private Practice 2264817410 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ivyrehab Michigan, LLC Occupational Therapist CurrentSince Feb 26, 2025 Accepting new patients

Locations

33111 Plymouth Rd
Livonia, MI 48150
Phone (248) 304-7027

1764 S Ortonville Rd
Ste 400
Ortonville, MI 48462
Phone (248) 793-5730

11488 Telegraph Rd
Ste 1
Taylor, MI 48180
Phone (734) 680-8077

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1661817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661817600000",
    "number": "1336869460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44670 ANN ARBOR RD W STE 130",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481704085",
            "telephone_number": "734-201-1542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44670 ANN ARBOR RD W STE 130",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481704085",
            "telephone_number": "734-201-1542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONG",
        "first_name": "KATHRYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-30",
        "last_updated": "2022-08-30",
        "certification_date": "2022-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.