DR. KELLY ANN LONG (NPI# 1457438905) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457438905 |
| Entity Type | Individual |
| Full Name | DR. KELLY ANN LONG |
| Credential | AU.D. |
| Practice Address |
15 Exchange Dr Lugoff SC 29078-9198 |
| Practice Telephone | 8034083277 |
| Practice Fax Number | 8034083299 |
| Mailing Telephone | 8034083277 |
| Mailing Fax Number | 8034083299 |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2020-05-26 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 231H00000X | Audiologist | 2008 | SC | Speech, Language and Hearing Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | SA0255 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013551894 | Kelly Denise Long | Physical Therapist | 6410 Diamond Rock Dr, Katy, TX 77449-4241 | 2019-11-04 |
| 1316319148 | Kelly Long | Occupational Therapist | 1906 Kenwood Ave, Charlotte, NC 28205-3646 | 2015-10-20 |
| 1013189703 | Kelly Elizabeth Long | Counselor | 115 W 5th, Emporia, KS 66801 | 2008-04-02 |
| 1720649676 | Kelly Long | Licensed Vocational Nurse | 2180 Valley Blvd, Pomona, CA 91768-3325 | 2019-06-21 |
| 1366949539 | Kelly Mckinley Long | Student in an Organized Health Care Education/Training Program | 477 Cooper Rd Ste 300, Westerville, OH 43081-8057 | 2018-04-12 |
| 1447551817 | Kelly Patricia Long | Nurse Practitioner | 900 E 13th St, Suite 101, Grove, OK 74344-2975 | 2010-11-16 |
| 1871808303 | Kelly A Long | Nurse Practitioner | 1025 Straka Ter, Oklahoma City, OK 73139-2544 | 2010-08-09 |
| 1447408133 | Kelly Long | Counselor | 615 Shipyard Blvd, Wilmington, NC 28412 | 2008-09-05 |
| 1568623338 | Kelly Lynn Long | Physician Assistant | 10909 Hannan Rd, Romulus, MI 48174-1383 | 2008-06-24 |
| 1457564726 | Kelly Long | Counselor | 15303 St. Rt 170, East Liverpool, OH 43920-9216 | 2007-05-07 |
| Street Address |
15 EXCHANGE DR |
| City | LUGOFF |
| State | SC |
| Zip Code | 29078-9198 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861499618 | Robert Kabakjian Sr. | Physician Assistant | 15 Exchange Dr, Lugoff, SC 29078-9198 | 2005-07-07 |
| 1760037360 | Maya Elizabeth James | Physician Assistant | 15 Exchange Dr, Lugoff, SC 29078-9198 | 2019-08-09 |
| 1043716228 | Felicia Denise Harris | Nurse Practitioner | 15 Exchange Dr, Lugoff, SC 29078-9198 | 2018-04-05 |
| 1952817835 | Rachel Chamberlin | Physician Assistant | 15 Exchange Dr, Lugoff, SC 29078-9198 | 2017-12-14 |
| 1285174664 | Kaitlin Prizzia | Audiologist | 15 Exchange Dr, Lugoff, SC 29078-9198 | 2017-03-03 |
| 1205247772 | Jason Paul Wigand | Audiologist | 15 Exchange Dr, Lugoff, SC 29078-9198 | 2014-05-18 |
| 1073958989 | Jacob Patrick Ossoff | Otolaryngology | 15 Exchange Dr, Lugoff, SC 29078-9198 | 2013-05-06 |
| 1447513643 | Valerie Alison Fritsch | Otolaryngology | 15 Exchange Dr, Lugoff, SC 29078-9198 | 2012-06-21 |
| 1316214638 | Lynnette Glasscho Tomlin | Physician Assistant | 15 Exchange Dr, Lugoff, SC 29078 | 2011-12-01 |
| 1932499159 | Natalie Vercillo Sciarrino | Otolaryngology | 15 Exchange Dr, Lugoff, SC 29078-9198 | 2011-04-08 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477006179 | Retireease Senior Services, Inc. | In Home Supportive Care | 12 Dooley Drive, Lugoff, SC 29078 | 2016-07-28 |
| 1770613515 | Claude Harold Varn Jr. | Dentist | P.0.box 325, Lugoff, SC 29078 | 2007-03-07 |
| 1316087364 | Ark Therapeutic Services, Inc | Speech-Language Pathologist | 862a Highway 1 South, Lugoff, SC 29078 | 2007-02-07 |
| 1326104837 | Allyson Varn Monferdini | Dentist | 25 Ward Road, Lugoff, SC 29078 | 2006-12-29 |
| 1275612269 | Wateree Plaza Drug Corp | Durable Medical Equipment & Medical Supplies | 1053 Hwy 1, Patterson Plaza, Lugoff, SC 29078 | 2006-11-02 |
| 1336589233 | Matthew Allen Nettles | Dentist | 25 Ward Road, Lugoff, SC 29078 | 2013-06-25 |
| 1013124429 | Debra C Lowsky | Speech-Language Pathologist | 862a Highway 1 South, Lugoff, SC 29078 | 2007-05-16 |
| 1285826396 | Durham Russell Maples | Chiropractor | 810 Ridgeway Road, Lugoff, SC 29078-0248 | 2007-08-13 |
| 1508059403 | Dina Maples Blankenship | Chiropractor | 810 Ridgeway Road, Lugoff, SC 29078-0248 | 2007-08-23 |
| 1104018852 | Wateree Chiropractic | Chiropractor | 810 Ridgeway Road, Lugoff, SC 29078-0248 | 2007-08-16 |
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| Taxonomy Code | 231H00000X |
| Grouping | Speech, Language and Hearing Service Providers |
| Classification | Audiologist |
| (1) A specialist in evaluation, habilitation and rehabilitation of those whose communication disorders center in whole or in part in hearing function. Audiologists are autonomous professionals who identify, assess, and manage disorders of the auditory, balance and other neural systems. Audiologists provide audiological (aural) rehabilitation to children and adults across the entire age span. Audiologists select, fit and dispense amplification systems such as hearing aids and related devices. (2) An audiologist is a person qualified by a master’s degree in audiology, licensed by the state, where applicable, and practicing within the scope of that license. Audiologists evaluate and treat patients with impaired hearing. They plan, direct and conduct rehabilitative programs with audiotry substitutional devises (hearing aids) and other therapy. |
| Notes: Source: (1) American Speech-Language-Hearing Association, (1996, Spring) Scope of practice in Audiology, p. 2 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285174664 | Kaitlin Prizzia | Audiologist | 15 Exchange Dr, Lugoff, SC 29078-9198 | 2017-03-03 |
| 1205247772 | Jason Paul Wigand | Audiologist | 15 Exchange Dr, Lugoff, SC 29078-9198 | 2014-05-18 |
| 1932418613 | Manda Werle-adams | Audiologist | 15 Exchange Dr, Lugoff, SC 29078-9198 | 2010-09-29 |
| 1811154396 | Kathryn Suzanne Mcgee | Audiologist | 15 Exchange Dr, Lugoff, SC 29078-9198 | 2008-05-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790391456 | Empire Audiology, LLC | Audiologist | 3536 W Bobo Newsom Hwy, Hartsville, SC 29550 | 2020-09-18 |
| 1376160465 | Nicole Ritter | Audiologist | 135 Rutledge Ave # 216, Charleston, SC 29425-8903 | 2020-07-06 |
| 1376197236 | Dakota Michael Sharp | Audiologist | 1705 College St Ste 220, Columbia, SC 29201-3917 | 2019-07-30 |
| 1003469156 | Hear Again LLC | Audiologist | 485 Chapin Rd Ste A, Chapin, SC 29036-8877 | 2019-07-18 |
| 1316411978 | Bbs Hearing Services LLC | Audiologist | 10239 Clemson Blvd Ste 170, Seneca, SC 29678-0862 | 2019-01-17 |
| 1700363769 | Jessica Lynn Mansur | Audiologist | 324 E Saint John St Ste B, Spartanburg, SC 29302-1505 | 2018-07-23 |
| 1942792031 | Hannah Louise Bannon | Audiologist | 4101 Main St Ste F, Hilton Head, SC 29926-4609 | 2018-06-04 |
| 1558853101 | Alexandra Michelle Taylor | Audiologist | 200 Patewood Dr Ste 400, Greenville, SC 29615 | 2018-05-30 |
| 1427562289 | The Beaufort Sound | Audiologist | 206 Sea Island Pkwy Ste 31, Beaufort, SC 29907-1526 | 2017-11-30 |
| 1770094161 | Hear Again LLC | Audiologist | 1 Wellness Blvd Ste 108, Irmo, SC 29063-2872 | 2017-10-12 |
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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.