Kevan Edward Long, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

A82620 Issued in CA

Practice address

3800 Janes Rd
Arcata, CA 95521-4742

Phone

(707) 826-8264

NPI assigned

May 4, 2007

Last updated

Aug 10, 2012By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Emergency Medicine

Education

University of Kansas School of Med (KC/Wich/Sal), 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

North Pacific Cardiology MedicalGroup PAC ID 8426113341, 21 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mad River Community Hospital Hospital, Arcata, CA, CCN 050028
• Providence St Joseph Hospital Hospital, Eureka, CA, CCN 050006

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• North Pacific Cardiology Medical

  • Internal Medicine Physician
  • Arcata, CA
  • NPI 1093821837
  Medicare reassignment Care Compare group NPD
• Centinela Freeman Emergency Medical Associates

  • Emergency Medicine Physician
  • Inglewood, CA
  • NPI 1962539684
  NPD (past)
• North Pacific Cardiology Medical Group

  • Emergency Medicine Physician
  • Arcata, CA
  • NPI 1902817059
  NPD (past)
• Six Rivers Emergency Physicians

  • Emergency Medicine Physician
  • Arcata, CA
  • NPI 1396786026
  NPD (past)
• The Covenant Group PA

  • Emergency Medicine Physician
  • Kansas City, KS
  • NPI 1306814389
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• American Hospital Management Corporation

  dba Mad River Community Hospital

  • General Acute Care Hospital
  • Arcata, CA
  • NPI 1518996040
  Care Compare affiliation
• St. Joseph Health Northern California, LLC

  dba Providence Humboldt Home Infusion

  • Home Infusion Therapy Pharmacy
  • Eureka, CA
  • NPI 1568422319

  Hospital

  Care Compare affiliation
• St. Joseph Health Northern California, LLC

  dba Providence St. Joseph Hospital

  • General Acute Care Hospital
  • Eureka, CA
  • NPI 1609858950
  Care Compare affiliation
• St. Joseph Health Northern California, LLC

  dba Providence St. Joseph Hospital

  • General Acute Care Hospital
  • Eureka, CA
  • NPI 1891900635
  Care Compare affiliation

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

{
    "created_epoch": "1178236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344556800000",
    "number": "1417169269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1524 HORRELL ST",
            "city": "MCKINLEYVILLE",
            "state": "CA",
            "postal_code": "955199467",
            "telephone_number": "785-851-8008",
            "fax_number": "707-839-1044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3800 JANES RD",
            "city": "ARCATA",
            "state": "CA",
            "postal_code": "955214742",
            "telephone_number": "707-826-8264"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONG",
        "first_name": "KEVAN",
        "middle_name": "EDWARD",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-04",
        "last_updated": "2012-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A82620",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Life Force Therapy, a Licensed Clinical Social Work Professional Corporation (Life Force Therapy)
• Life on Wheels LLC (Life On Wheels)
• Shay Little
• Ian Lockwood
• Max D Loginov, LCSW
• Michelle Long
• Longs Drug Stores California LLC (CVS Pharmacy #09482)
• Kim Susane Lopez
• Sabrina Lopez
• Lost Coast Family Therapy

• Emergency Medicine Physician in Arcata, CA
• Providers in Arcata, CA by specialty
• Emergency Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.