Kelly Patricia Long, APRN, CPNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

61374 Issued in OK

Practice address

900 E 13TH St
Suite 101
Grove, OK 74344-2975

Phone

(918) 786-9900

Fax

(918) 786-9904

NPI assigned

Nov 16, 2010

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 2

Medicare fee-for-service enrollment

Enrolled in OK

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Pediatric Nurse Practitioner, Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: klong11733@direct.integrisok.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.

• Integris Ambulatory Care Corporation

  • Family Medicine Physician
  • Oklahoma City, OK
  • NPI 1750333936
  Medicare reassignment NPD
• Integris Grove Hospital

  • Rural Health Clinic/Center
  • Grove, OK
  • NPI 1134720592
  Medicare reassignment NPD
• Integris Grove Hospital

  • General Acute Care Hospital
  • Grove, OK
  • NPI 1467473579
  NPD
• Integris Grove Hospital

  • Rural Health Clinic/Center
  • Grove, OK
  • NPI 1689274391
  NPD
• Integris Ambulatory Care C Orporation

  • Family Medicine Physician
  • Oklahoma City, OK
  • NPI 1326076027
  NPD (past)
• Integris Rural Health Inc

  • Family Medicine Physician
  • Mustang, OK
  • NPI 1962403030
  NPD (past)

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

{
    "created_epoch": "1289865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491350400000",
    "number": "1447551817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5300 N INDEPENDENCE AVE",
            "address_2": "280",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731125556",
            "telephone_number": "918-786-9900",
            "fax_number": "918-786-9904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 E 13TH ST",
            "address_2": "SUITE 101",
            "city": "GROVE",
            "state": "OK",
            "postal_code": "743442975",
            "telephone_number": "918-786-9900",
            "fax_number": "918-786-9904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONG",
        "first_name": "KELLY",
        "middle_name": "PATRICIA",
        "name_prefix": "Ms.",
        "credential": "APRN, CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-16",
        "last_updated": "2017-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "OK",
            "license": "61374",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200311440A",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200505990H",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Angela Littlejohn
• Lani Michaele Littlejohn, RN, BSN
• Stephany Leann Littlejohn, PTA
• Robert C. Livesay, LMF
• Julie D Londagin, CCC-SLP
• Tessa Lynn Longan, APRN-CNP
• Michaela Lovejoy, OTR/L
• Kelli Lee Lowry
• LT Lantz Inc
• Patricia Major

• Pediatric Nurse Practitioner in Grove, OK
• Providers in Grove, OK by specialty
• Pediatric Nurse Practitioner in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2017; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.