DR. KENNETH MICHAEL LONG (NPI# 1346535390) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346535390 |
| Entity Type | Individual |
| Full Name | DR. KENNETH MICHAEL LONG |
| Credential | D.O. |
| Practice Address |
2750 Gause Blvd E Slidell LA 70461 |
| Mailing Address |
1514 Jefferson Hwy New Orleans LA 70121-2429 |
| Practice Telephone | 9856393777 |
| Practice Fax Number | 9856393701 |
| Mailing Telephone | 5048424000 |
| Enumeration Date | 2011-06-17 |
| Last Update Date | 2019-03-21 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 311654 | LA | Allopathic & Osteopathic Physicians |
| N | 207Q00000X | Family Medicine | 22826 | MS | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | RAILROAD MEDICARE | P01332510 | 01 |
| MS | 08224277 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 128 Highland Pkwy Ste 200, Picayune, MS 394665578 | 6013589630 | 6013589640 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598997207 | Kenneth Alan Long | Interpreter | 16817 223rd Ave E, Orting, WA 98360-9120 | 2009-08-13 |
| 1982605911 | Kenneth D Long | Physician Assistant | 1251 Ne Elm St, Prineville, OR 97754 | 2005-08-01 |
| 1952936163 | Kenneth Long | Student in an Organized Health Care Education/Training Program | 611 W Park St, Urbana, IL 61801-2529 | 2020-03-08 |
| 1467949974 | Kenneth Long | Behavior Technician | 630 Southpointe Ct Ste 105, Colorado Springs, CO 80906-3800 | 2018-04-19 |
| 1255715660 | Kenneth Long | Counselor | 1273 S 2nd St, Raton, NM 87740-2234 | 2015-07-15 |
| 1730462219 | Kenneth G Long | Pharmacist | 1050 N Kennedy Dr, Kankakee, IL 60901-2033 | 2011-09-21 |
| 1720287253 | Kenneth Lamar Long | Psychologist | 1254 Ocala Rd, Tallahassee, FL 32304-1548 | 2007-07-14 |
| 1831215656 | Kenneth Long | Case Manager/Care Coordinator | 2707 Browns Ln, Jonesboro, AR 72401-7213 | 2007-03-22 |
| 1932125846 | Kenneth Lee Long | Internal Medicine | 1305 Wonder World Drive, Ste 301, San Marcos, TX 78666 | 2006-07-14 |
| 1114971991 | Kenneth W Long | Family Medicine | 1395 El Rito Dr, Gulf Breeze, FL 32563-6707 | 2006-05-19 |
| Street Address |
2750 GAUSE BLVD E |
| City | SLIDELL |
| State | LA |
| Zip Code | 70461 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932106952 | Karen Adeline Purdy | Family Medicine | 2750 Gause Blvd E, Slidell, LA 70461-4149 | 2005-07-05 |
| 1427665058 | Sherry Kern | Nutritionist | 2750 Gause Blvd E, Slidell, LA 70461-4149 | 2020-09-28 |
| 1245860725 | Cadence Tara Griffing | Family Medicine | 2750 Gause Blvd E, Slidell, LA 70461-4149 | 2020-01-23 |
| 1811471451 | Heather S. Rezza | Nurse Practitioner | 2750 Gause Blvd E, Slidell, LA 70461-4149 | 2018-09-19 |
| 1609359843 | Megan Minter Lemon | Nurse Practitioner | 2750 Gause Blvd E, Slidell, LA 70461-4149 | 2018-09-13 |
| 1053803551 | Pleshetta Dewan Dillon Jackson | Nurse Practitioner | 2750 Gause Blvd E, Slidell, LA 70461-4149 | 2018-05-31 |
| 1295266419 | Andrea Juneau | Physician Assistant | 2750 Gause Blvd E, Slidell, LA 70461-4149 | 2017-03-21 |
| 1952840407 | Lien Fradella | Nurse Practitioner | 2750 Gause Blvd E, Slidell, LA 70461-4149 | 2017-02-16 |
| 1861871949 | Ashley Simon | Family Medicine | 2750 Gause Blvd E, Slidell, LA 70461-4149 | 2015-05-22 |
| 1619378148 | Lisa Marie Guzman | Nurse Practitioner | 2750 Gause Blvd E, Slidell, LA 70461-4149 | 2014-09-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013553577 | Kira Gilmore Smith | Nurse Practitioner | Pelican Urgent Care, 2375 Gause Blvd. East, Slidell, LA 70461 | 2019-11-20 |
| 1104477256 | Peter Khong | Pharmacy | 2915 Us-190, Mandeville, LA 70461 | 2019-09-20 |
| 1457844706 | April Hughes Whitfield | Counselor | 1313 Brownswitch Rd, Ste D, Slidell, LA 70461 | 2018-06-12 |
| 1154824761 | Lisa Michele Mcclinton | Counselor | 1212 Montgomery Blvd, Slidell, LA 70461 | 2018-03-10 |
| 1952816902 | Keiona Monae Thompson | Counselor | 1121 Clairise Ct, Slidell, LA 70461 | 2017-12-12 |
| 1275048688 | Aisha Cade | Counselor | 250 Cross Gates Blvd, Slidell, LA 70461 | 2017-12-07 |
| 1598285405 | Sureway Transits | Non-emergency Medical Transport (VAN) | 135 Rue De La Paix, Slidell, LA 70461 | 2017-06-21 |
| 1043743198 | Natasha Hunter | Counselor | 1650 Barrymore St, Slidell, LA 70461 | 2017-04-05 |
| 1154873891 | Chaise A Bennett | Physical Therapist | 2040 Gause Blvd, Suite 6, Slidell, LA 70461 | 2016-10-28 |
| 1104373539 | Kaonta Simmons | Counselor | 2185 Wellington Ln, Slidell, LA 70461 | 2016-09-01 |
| Find all providers in zip 70461 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316575434 | Southern Healthcare of Louisiana | Family Medicine | 1340 Gause Blvd W, Slidell, LA 70460 | 2020-04-01 |
| 1598311029 | Southern Louisiana Medical Group, LLC | Family Medicine | 2104 Gause Blvd W Ste A, Slidell, LA 70460-4130 | 2019-08-12 |
| 1962960302 | Robert Weiss | Family Medicine | 13 S Treasure Isle, Slidell, LA 70461-1110 | 2019-03-05 |
| 1508378118 | Jembber Robinson | Family Medicine | 1570 Lindberg Dr Ste 14, Slidell, LA 70458-8084 | 2017-11-05 |
| 1336405711 | Stephanie N Seasly | Family Medicine | 360 Gateway Dr, Suite B, Slidell, LA 70461-5595 | 2012-04-10 |
| 1841434404 | Hatem Fikry Ahmed Hamed | Family Medicine | 360 Gateway Dr Ste B, Slidell, LA 70461-5596 | 2009-04-27 |
| 1306014667 | Robert L Tassin Jr. | Family Medicine | 119 White Stork Dr, Slidell, LA 70461-3207 | 2008-02-20 |
| 1346364544 | Tradina Pichon | Family Medicine | 1414 Gause Blvd, Suite 16, Slidell, LA 70458-2265 | 2007-03-16 |
| 1962598540 | Gilo Kawasaki | Family Medicine | 60491 Doss Dr, Slidell, LA 70460-4972 | 2006-10-04 |
| 1730149329 | Rory J Duffour | Family Medicine | 901 Gause Blvd Ste 100, Slidell, LA 70458 | 2006-03-27 |
| Find all providers in SLIDELL | ||||
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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.