Kathy Amanda Long, ARNP-BC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

3092927 Issued in KY

Practice address

108 Airway Dr
Marion, IL 62959-5841

Phone

(618) 997-7820

Fax

(618) 997-6721

NPI assigned

Nov 15, 2006

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

Other identifiers 1

Other names 1

• Miss Kathy Amanda Jones Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: kathylong@thepainmd.ssdirect.aprima.com

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.

• Kenney Orthopedics of Paducah, LLC

  • Prosthetic/Orthotic Supplier
  • Paducah, KY
  • NPI 1013385558
  NPD (past)
• Pain Management Centers of America, PSC

  • Interventional Pain Medicine Physician
  • Hopkinsville, KY
  • NPI 1326510181
  NPD (past)

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582070400000",
    "number": "1407929870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2831 LONE OAK RD",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420038041",
            "telephone_number": "270-554-8373",
            "fax_number": "270-554-8987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 AIRWAY DR",
            "city": "MARION",
            "state": "IL",
            "postal_code": "629595841",
            "telephone_number": "618-997-7820",
            "fax_number": "618-997-6721"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "67 Lakeview Dr",
            "address_purpose": "LOCATION",
            "city": "Paducah",
            "state": "KY",
            "postal_code": "420015619",
            "country_code": "US",
            "telephone_number": "270-554-8373",
            "fax_number": "270-554-8987",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LONG",
        "first_name": "KATHY",
        "middle_name": "AMANDA",
        "name_prefix": "Miss",
        "credential": "ARNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-15",
        "last_updated": "2020-02-19",
        "certification_date": "2020-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "3092927",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "78905296",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHY",
            "last_name": "JONES",
            "middle_name": "AMANDA",
            "prefix": "MISS",
            "credential": "ARNP",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Meth Linwong, M.D.
• Jay I Lipoff, MD
• Denise Little, RN
• Xingtong Liu
• Monette R Logue, BSW
• Mary Elizabeth Long, RN
• Sandra Kay Long, RD, LD
• Andrea Caroline Lopez, SSP, NCSP
• Luis A Lopez, M.D.
• Daniele Christine Loyd, RN

• Nurse Practitioner in Marion, IL
• Providers in Marion, IL by specialty
• Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.