Individual provider Active NPI

Elizabeth Anne Long, PH.D.

  • Clinical Neuropsychologist
  • Kent, OH
National Provider Identifier
1487058111
Registry record updated Dec 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
7215 Issued in OH
Practice address
190 Currie Hall Pkwy
Kent, OH 44240-4312
Phone
(614) 598-3316
NPI assigned
Oct 8, 2014
Last updated
Dec 10, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 7215 OH Primary

Addresses

Primary practice location

190 Currie Hall Pkwy
Kent, OH 44240-4312

Mailing address

190 Currie Hall Pkwy
Kent, OH 44240-4312

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141126001742 OH Practitioner - Clinical Psychologist 9335461433 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gary Robinson and Associates LLCGroup PAC ID 5799748919, 13 clinicians

Practice addresses (Care Compare)

190 Currie Hall Pkwy
Kent, OH 44240-4312
Phone (330) 673-5812

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Gary Robinson & Associates LLC CurrentSince Nov 1, 2014 Accepting new patients

Locations

190 Currie Hall Pkwy
Kent, OH 44240
Phone (330) 673-5812

190 Currie Hall Pkwy
#A
Kent, OH 44240
Phone (330) 673-5212

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1412726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418169600000",
    "number": "1487058111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 CURRIE HALL PKWY",
            "city": "KENT",
            "state": "OH",
            "postal_code": "442404312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 CURRIE HALL PKWY",
            "city": "KENT",
            "state": "OH",
            "postal_code": "442404312",
            "telephone_number": "614-598-3316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONG",
        "first_name": "ELIZABETH",
        "middle_name": "ANNE",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-08",
        "last_updated": "2014-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "OH",
            "license": "7215",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kent, OH

Sources for this page

Verify at the official NPI Registry.