KATHERINE MARIE LONG (NPI# 1134495484) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134495484 |
| Entity Type | Individual |
| Full Name | KATHERINE MARIE LONG |
| Credential | PA |
| Practice Address |
1225 N State St Surgery Jackson MS 39202-2064 |
| Mailing Address |
965 Ridge Lake Blvd Ste 103 Memphis TN 38120-9446 |
| Practice Telephone | 6019687047 |
| Practice Fax Number | 6019684133 |
| Mailing Telephone | 9012273255 |
| Mailing Fax Number | 9012278591 |
| Enumeration Date | 2012-03-30 |
| Last Update Date | 2018-03-29 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
TPA0023 | MS | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316483555 | Katherine Long | Massage Therapist | 1409 W Main St Ste 100, Boise, ID 83702-5202 | 2017-01-11 |
| 1316278005 | Katherine Knoll Long | Physical Therapist | 3280 Dauphin St Ste A103, Mobile, AL 36606-4048 | 2010-01-20 |
| 1598301194 | Katherine S Long | Nurse Practitioner | 3500 Arendell St, Morehead City, NC 28557-2901 | 2019-11-19 |
| 1326515685 | Katherine Long | Counselor | 4030 Mount Carmel Tobasco Rd Ste 102, Cincinnati, OH 45255-3408 | 2018-10-25 |
| 1912421827 | Katherine Long | Occupational Therapist | 8507 Ne 8th Way, Vancouver, WA 98664-1980 | 2017-08-01 |
| 1902349301 | Katherine Spalding Long | Speech-Language Pathologist | 480 Cadys Falls Rd, Morristown, VT 05661-9137 | 2016-12-02 |
| 1275085854 | Katherine Long | Nurse Practitioner | 2000 Circle of Hope Dr, Salt Lake City, UT 84112-5550 | 2016-10-28 |
| 1265882229 | Katherine Long | Skilled Nursing Facility | 7600 Autumn Park Way, Mechanicsville, VA 23116-3868 | 2016-06-20 |
| 1154715530 | Katherine Long | Physical Therapist | 536 Old Howell Rd, Greenville, SC 29615-1969 | 2015-03-24 |
| 1316368152 | Katherine Long | Speech-Language Pathologist | 4443 Rowan Rd, New Port Richey, FL 34653-6198 | 2013-12-20 |
| Street Address |
1225 N STATE ST SURGERY |
| City | JACKSON |
| State | MS |
| Zip Code | 39202-2064 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013919216 | Richard B Friedman | Radiology | 1225 N State St, Jackson, MS 39202-2064 | 2005-06-01 |
| 1326649336 | Sharron Rena Brown | Nurse Practitioner | 1225 N State St, Jackson, MS 39202-2097 | 2020-11-05 |
| 1861009714 | April Stevenson Corcoran | Registered Nurse | 1225 N State St, Jackson, MS 39202-2064 | 2020-09-24 |
| 1609485440 | Mississippi Baptist Medical Center, Inc. | Clinical Medical Laboratory | 1225 N State St, Jackson, MS 39202-2064 | 2020-07-28 |
| 1912530569 | Brandi Burge Wagner | Nurse Practitioner | 1225 N State St, Jackson, MS 39202-2064 | 2020-02-21 |
| 1760028955 | Erin Jones | Registered Nurse | 1225 N State St, Jackson, MS 39202-2064 | 2019-11-21 |
| 1780229641 | Lauren Blakeney | Nurse Practitioner | 1225 N State St, Jackson, MS 39202-2064 | 2019-11-14 |
| 1417591322 | Lou Ann Wells | Registered Nurse | 1225 N State St, Jackson, MS 39202-2064 | 2019-11-04 |
| 1861043531 | Jessica Candace Cody | Anesthesiology | 1225 N State St, Jackson, MS 39202-2064 | 2019-09-24 |
| 1386290955 | Brady K Lowery | Nurse Practitioner | 1225 N State St, Jackson, MS 39202-2064 | 2019-08-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982234183 | Eva Mackenzie Carmody | Physician Assistant | 1190 N State St Suite 502, Jackson, MS 39202 | 2020-01-16 |
| 1750868691 | Katherine Walters | Nurse Practitioner | 501 Marshall St., Suite 400, Jackson, MS 39202 | 2018-07-24 |
| 1932638749 | Tylan Lee | Social Worker | 860 East River Place Suite 100, Jackson, MS 39202 | 2017-06-06 |
| 1417314725 | Euna Jyles | Counselor | 860 E River Pl, Jackson, MS 39202 | 2016-01-19 |
| 1255712048 | Edward Jonathan Breight | Specialist/Technologist | 1325 East Fortication Street, Jackson, MS 39202 | 2015-06-17 |
| 1881037703 | Kara Spinks Logan | Surgery | 1190 N State St Ste 502, Jackson, MS 39202 | 2013-04-10 |
| 1477876530 | Mick Inc. | Technician | 334 Josanna Street, Suite #209, Jackson, MS 39202 | 2010-03-03 |
| 1073724910 | Paul Frederic Dare | Anesthesiology | 1151 North State St., Suite 311, Jackson Anesthesia Associates, Jackson, MS 39202 | 2007-05-24 |
| 1225247703 | Lynn Kincannon Holland | Counselor | 911 Manship Street, Unit A, Jackson, MS 39202 | 2007-05-22 |
| 1457568149 | Incare Inc | Pulmonary Function Technologist | 1151 North State St, Suite 406, Jackson, MS 39202 | 2007-05-16 |
| Find all providers in zip 39202 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477091742 | Madeline Grace Daniels | Physician Assistant | 501 Marshall St Ste 400, Jackson, MS 39202-1687 | 2017-02-07 |
| 1972133353 | Justin Bryant Schopp | Physician Assistant | 1325 E Fortification St, Jackson, MS 39202-2442 | 2020-01-24 |
| 1275163727 | Kaitlin Lehto | Physician Assistant | 971 Lakeland Dr Ste 1460, Jackson, MS 39216-4684 | 2020-01-23 |
| 1154951739 | Hailey Daniels Kelly | Physician Assistant | 1325 E Fortification St, Jackson, MS 39202-2442 | 2020-01-22 |
| 1205466984 | Rachel Sellers | Physician Assistant | 971 Lakeland Dr Ste 1460, Jackson, MS 39216-4621 | 2020-01-22 |
| 1194284786 | Kaitlyn Dunbar | Physician Assistant | 2500 N State St, Jackson, MS 39216-4500 | 2019-03-14 |
| 1164920930 | Catherine Supple Bryant | Physician Assistant | 1190 N State St Ste 502, Jackson, MS 39202-2414 | 2018-01-26 |
| 1790293496 | Madison Holcomb | Physician Assistant | 971 Lakeland Dr Ste 1460, Jackson, MS 39216-4621 | 2018-01-16 |
| 1902314693 | Sarah Lindsey Abdeen | Physician Assistant | 971 Lakeland Dr Ste 1460, Jackson, MS 39216-4621 | 2018-01-16 |
| 1083073233 | Mary Allison Durr | Physician Assistant | 1325 E Fortification St, Jackson, MS 39202-2442 | 2016-02-16 |
| Find all providers in JACKSON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.