Active NPI
Clarissa Anne Long, DO
- Family Medicine Physician
- Athens, TX
National Provider Identifier
1245922103
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- V9652
- Practice address
- 115 Medical Cir Ste 100
Athens, TX 75751-9004 - Phone
- (903) 603-7067
- Fax
- (903) 603-7595
- NPI assigned
- May 22, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | V9652 | TX | Primary |
Addresses
Primary practice location
115 Medical Cir Ste 100
Athens, TX 75751-9004
Mailing address
PO Box 1610
Athens, TX 75751-1610
Phone (903) 603-7067
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230914003846 | TX | Order and Referring Only - Family Practice | 1355705930 |
Care Compare profile
Medicare Care Compare- Specialty
- Osteopathic Manipulative Medicine
- Education
- Lincoln Mem Univ, Debusk Col of Osteopathic Med, 2023
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
115 Medical Cir
Suite 100
Athens, TX 75751-9005
11937 US Hwy 271
Tyler, TX 75708-3154
PO Box
Suite 1610
Athens, TX 75751
PO Box
Suite 5478
Pawtucket, RI 02862
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
Interoperability endpoints
- clong876830@ahs.direct-ci.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1684713600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1784764800000",
"number": "1245922103",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1610",
"city": "ATHENS",
"state": "TX",
"postal_code": "757511610",
"telephone_number": "903-603-7067",
"fax_number": "903-603-7595"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "115 MEDICAL CIR STE 100",
"city": "ATHENS",
"state": "TX",
"postal_code": "757519004",
"telephone_number": "903-603-7067",
"fax_number": "903-603-7595"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LONG",
"first_name": "CLARISSA",
"middle_name": "ANNE",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-05-22",
"last_updated": "2026-07-23",
"certification_date": "2026-07-23",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "TX",
"license": "V9652",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Athens, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.