Organization Active NPI

Kent C Long DC Inc

  • Rehabilitation Chiropractor
  • Dayton, OH
National Provider Identifier
1386771673
Registry record updated Nov 18, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation ChiropractorTaxonomy code 111NR0400X
License
1362 Issued in OH
Legal business name
KENT C LONG DC INC
Practice address
4978 Northcutt PL
Dayton, OH 45414-3840
Phone
(937) 278-7246
Fax
(937) 278-5640
NPI assigned
Feb 27, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2009

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

Authorized official

Name
Dr. Kent Charles Long, D.C.NPI 1649323379
Title
Owner
Phone
(937) 278-7246

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111NR0400X 1362 OH Primary

Addresses

Primary practice location

4978 Northcutt PL
Dayton, OH 45414-3840

Mailing address

4978 Northcutt PL
Dayton, OH 45414-3840
Phone (937) 278-7246

Other names 1

  • Long Chiropractic Office Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091020000588 OH Part B Supplier - Clinic/Group Practice 9436182557 Receives reassigned benefits from 1 practitioner
Practice locations: Centerville, OH; Dayton, OH

National Provider Directory

National Provider Directory

Locations

4978 Northcutt Pl
Dayton, OH 45414
Phone (937) 278-7246

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1258502400000",
    "number": "1386771673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4978 NORTHCUTT PL",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454143840",
            "telephone_number": "937-278-7246",
            "fax_number": "937-278-5640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4978 NORTHCUTT PL",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454143840",
            "telephone_number": "937-278-7246",
            "fax_number": "937-278-5640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENT C LONG DC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-27",
        "last_updated": "2009-11-18",
        "status": "A",
        "authorized_official_last_name": "LONG",
        "authorized_official_first_name": "KENT",
        "authorized_official_middle_name": "CHARLES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "937-278-7246",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor, Rehabilitation",
            "state": "OH",
            "license": "1362",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Long Chiropractic Office",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dayton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2009; 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.