MR. KENNETH D LONG NPI 1982605911

NPI Information

  • NPI: 1982605911
  • Provider Name: MR. KENNETH D LONG
  • Classification: Physician Assistant - 363A00000X
  • Entity Type: Individual
  • Address: 1251 NE ELM ST
    PRINEVILLE, OR
    ZIP 97754
  • Phone: (541) 447-1680

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NPI Details

MR. Kenneth D Long is a physician assistant in Prineville, OR. The provider is a physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. MR. Kenneth D Long NPI is 1982605911. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1251 NE ELM ST
PRINEVILLE, OR
ZIP 97754
Phone: (541) 447-1680
Fax: (541) 447-4670

The enumeration date for this NPI number is 8/1/2005 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363A00000XPhysician AssistantPA00535OREGONYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1205625MEDICAIDOREGON
213503OTHERCLEAR CHOICE
3H3079OTHERPACIFIC SOURCE
4R106865MEDICARE ID-TYPE UNSPECIFIEDOREGON
5GRP331OTHERPROVIDENCE HEALTH PLANS
613503OTHERCOIHS
793071013397754A001OTHERTRICARE WEST
89700113590OTHERRAILROAD MEDICARE
9S95185MEDICARE UPIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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