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KELLY LONG DO
NPI 1033979497
Student in an Organized Health Care Education/Training Program in Little Rock, AR

Active since March 21, 2024PECOS Enrolled
4301 W MARKHAM ST # 584, LITTLE ROCK, AR 72205(501) 686-6996 Get Directions Write a Review

NPPES record last updated: March 21, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Kelly Long Do NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KELLY LONG DO (NPI 1033979497) is an individual student in an organized health care education/training program in Little Rock, Arkansas and active in the NPI registry since March 2024. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1033979497
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NameKELLY LONGCredential: DO
Location Address4301 W MARKHAM ST # 584Little Rock, AR 72205-7101
Mailing Address4301 W Markham St # 584Little Rock, AR 72205-7101 · (501) 686-6996
Phone(501) 686-6996
Sole ProprietorYes
Enumeration DateMarch 21, 2024
NPPES CertifiedMarch 21, 2024
✔ NPI 1033979497 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
4301 W MARKHAM ST # 584, Little Rock, AR 72205
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kelly Long Do is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

GITANSH BHARGAVA DO
Emergency Medicine
4301 W MARKHAM ST # 584
LITTLE ROCK, AR 72205
Pulaski County (501) 686-8000
MATT SAENZ
Student in an Organized Health Care Education/Training Program
4301 W MARKHAM ST # 584
LITTLE ROCK, AR 72205
Pulaski County (501) 526-7485
MELISSA PAIGE DAILEY MD
Emergency Medicine
4301 W MARKHAM ST # 584
LITTLE ROCK, AR 72205
Pulaski County (501) 526-7485
NHAN H PHAN MD
Internal Medicine (Critical Care Medicine)
4301 W MARKHAM ST # 584
LITTLE ROCK, AR 72205
Pulaski County (501) 686-5515
BRENDAN MOORE MD
Emergency Medicine
4301 W MARKHAM ST # 584
LITTLE ROCK, AR 72205
Pulaski County (501) 562-2085
DR. MATTHEW JOHN DENEFE MD
Emergency Medicine
4301 W MARKHAM ST # 584
LITTLE ROCK, AR 72205
Pulaski County (501) 686-6996
MARCELLE THERESA FOURNET
Student in an Organized Health Care Education/Training Program
4301 W MARKHAM ST # 584
LITTLE ROCK, AR 72205
Pulaski County (501) 686-7000
JACK DOUGLAS SUDDUTH MD, MS
Student in an Organized Health Care Education/Training Program
4301 W MARKHAM ST # 584
LITTLE ROCK, AR 72205
Pulaski County (501) 526-7485

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kelly Long's NPI number?

The NPI number for Kelly Long is 1033979497. It was assigned to this individual provider in the NPPES registry on March 21, 2024.

Where is Kelly Long located?

Kelly Long practices at 4301 W Markham St # 584, Little Rock, AR 72205. The listed phone number is (501) 686-6996.

What is Kelly Long's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Kelly Long enrolled in Medicare?

Yes. Kelly Long is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Kelly Long was last updated on March 21, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.