Ian Long
Student in an Organized Health Care Education/Training Program in Clarksville, TN. Individual provider (NPI-1).
NPI number1538091079
StatusActive
Last updated in NPPESJun 1, 2026
Details
- NPI
- 1538091079
- Entity type
- Individual (NPI-1)
- Name
- Ian Long
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jun 1, 2026
- Certification date
- May 31, 2026
- Last updated
- Jun 1, 2026
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – | Yes |
| 2255A2300X | Specialist/Technologist, Athletic Trainer | – | – |
Practice location
3071 Timberdale DrClarksville, TN 37042-8855
Phone 931-263-4154
Mailing address
3071 Timberdale DrClarksville, TN 37042-8855
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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All 16 Student in an Organized Health Care Education/Training Program providers in Clarksville · All 4,403 providers in Clarksville
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