Michigan Infusion and Licensed Healthcare
NPI 1164153367ActiveOrganization· Physician Assistant· Plymouth, MI
Physician Assistant in Plymouth, Michigan, registered in NPPES in June 2022. The authorized official on file is Kelly L. Long, PA-C, Owner/Manager.
Overview
| NPI | 1164153367 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jun 20, 2022 |
| Last updated in NPPES | Jun 20, 2022 |
| Certified by provider | Jun 20, 2022 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physician Assistant Primary | 363A00000X | — | — |
| Physical Medicine & Rehabilitation, Pain Medicine | 2081P2900X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
Other physician assistants in Plymouth
- 1083988323
- 1255565685
- 1659905156
- 1811598162
- 1205592292
- 1447629795
- 1861024606
- 1073061222
- 1386376093
- 1467552968
- 1023740149
- 1043812308
All 17 physician assistants in Plymouth · All physician assistants in Michigan