NPIMap

Individual provider Active NPI

Jessica Ruth Thiessen Long, M.D.

  • Family Medicine Physician
  • Sunbury, OH
National Provider Identifier
1285873919
Registry record updated Jan 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35.095047 Issued in OH
Practice address
100 Tippett CT
Suite 101
Sunbury, OH 43074-8572
Phone
(740) 965-3123
Fax
(740) 965-9713
NPI assigned
Feb 19, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 35.095047 OH Primary

Addresses

Primary practice location

100 Tippett CT
Suite 101
Sunbury, OH 43074-8572

Mailing address

L-3401
Columbus, OH 43260-3401
Phone (740) 615-1324

Other identifiers 1

IdentifierTypeStateIssuer
3144869MedicaidOH

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jthiessenlong54893@direct.ohiohealth.com OhioHealth Physician Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110701000231 OH Practitioner - Family Practice 6608054143 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Ohio State University College of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ohiohealth CorporationGroup PAC ID 6305758426, 2,295 clinicians

Practice addresses (Care Compare)

393 E Town St
Suite 116
Columbus, OH 43215-4799
Phone (614) 566-9108

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35.095047OHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ohiohealth Corporation Family Medicine CurrentSince Jun 1, 2016 Accepting new patients
Ohiohealth Corporation CurrentSince Jun 1, 2016 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

393 E Town St
Ste 116
Columbus, OH 43215
Phone (614) 566-9108

Dept L3652
Columbus, OH 43260

5400 Frantz Rd
Ste 250
Dublin, OH 43016
Phone (614) 544-6161

4141 N Hampton Dr
Ste 103
Powell, OH 43065
Phone (740) 615-2850

4141 N Hampton Dr
Ste 100
Powell, OH 43065
Phone (614) 764-0200

100 Tippett Ct
Ste 101
Sunbury, OH 43074
Phone (740) 965-3123

100 Tippett Ct
Sunbury, OH 43074
Phone (614) 431-1634

Interoperability endpoints

  • Direct secure messaging: jessica.thiessen-long.1@20411.direct.athenahealth.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1235001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641340800000",
    "number": "1285873919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "L-3401",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432603401",
            "telephone_number": "740-615-1324",
            "fax_number": "740-615-1344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 TIPPETT CT",
            "address_2": "SUITE 101",
            "city": "SUNBURY",
            "state": "OH",
            "postal_code": "430748572",
            "telephone_number": "740-965-3123",
            "fax_number": "740-965-9713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THIESSEN LONG",
        "first_name": "JESSICA",
        "middle_name": "RUTH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-02-19",
        "last_updated": "2022-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35.095047",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3144869",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jthiessenlong54893@direct.ohiohealth.com",
            "affiliation": "Y",
            "affiliationName": "OhioHealth Physician Group",
            "address_1": "100 Tippett Ct",
            "address_2": "Ste 101",
            "city": "Sunbury",
            "state": "OH",
            "country_code": "US",
            "postal_code": "430748572",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Sunbury, OH

Sources for this page

Verify at the official NPI Registry.