Individual provider Active NPI

Katharine Christina Long, M.D

  • Pediatric Emergency Medicine (Pediatrics) Physician
  • Madera, CA
National Provider Identifier
1639443104
Registry record updated Jul 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Emergency Medicine (Pediatrics) PhysicianTaxonomy code 2080P0204X
License
MD452181 Issued in PA
Practice address
9300 Valley Childrens PL
Valley Children's Hospital
Madera, CA 93636-8761
Phone
(717) 586-0629
NPI assigned
Mar 1, 2012
Last updated
Jul 12, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 12, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A119576 CA
Pediatric Emergency Medicine (Pediatrics) Physician 2080P0204X MD452181 PA Primary

Addresses

Primary practice location

9300 Valley Childrens PL
Valley Children's Hospital
Madera, CA 93636-8761

Mailing address

1830 N Sanders Ave
Clovis, CA 93619-2010
Phone (717) 586-0629

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20180918002959 WA Practitioner - Pediatric MedicinePractitioner - Emergency Medicine 7618196684 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A119576CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Multicare Health System CurrentSince Jul 11, 2018 Accepting new patients
Multicare Health System Current Accepting new patients
Multicare Health System CurrentSince Jul 11, 2018 Accepting new patients
Multicare Health System Past Accepting new patients
Multicare Health System Past Accepting new patients
Multicare Health System Family Medicine Past Accepting new patients
Valley Children's Hospital Past Accepting new patients

Locations

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

222 State Ave N
Kent, WA 98030
Phone (253) 372-7680

200 Lilly Rd NE
Ste C
Olympia, WA 98506
Phone (360) 918-8336

315 S K St
Tacoma, WA 98405
Phone (253) 403-1291

317 Martin Luther King Jr Way
Tacoma, WA 98405
Phone (253) 403-1400

Interoperability endpoints

  • Direct secure messaging: klong76140@valleychildrens-prd.direct-ci.com

Organizations & group practices 7

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": "1330560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468281600000",
    "number": "1639443104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1830 N SANDERS AVE",
            "city": "CLOVIS",
            "state": "CA",
            "postal_code": "936192010",
            "telephone_number": "717-586-0629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9300 VALLEY CHILDRENS PL",
            "address_2": "VALLEY CHILDREN'S HOSPITAL",
            "city": "MADERA",
            "state": "CA",
            "postal_code": "936368761",
            "telephone_number": "717-586-0629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONG",
        "first_name": "KATHARINE",
        "middle_name": "CHRISTINA",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-03-01",
        "last_updated": "2016-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A119576",
            "primary": false
        },
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "PA",
            "license": "MD452181",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madera, CA

Sources for this page

Verify at the official NPI Registry.