Individual provider Active NPI

Clarice Long, DPT

  • Physical Therapist
  • Levelland, TX
National Provider Identifier
1609355197
Registry record updated Mar 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1307671 Issued in TX
Practice address
410 Avenue G
Levelland, TX 79336-3719
Phone
(806) 897-0540
Fax
(806) 897-0542
NPI assigned
Aug 7, 2018
Last updated
Mar 2, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 1307671 TX Primary

Addresses

Primary practice location

410 Avenue G
Levelland, TX 79336-3719

Mailing address

9107 Milwaukee Ave
Lubbock, TX 79424
Phone (806) 687-4311

Other practice location 1

9107 Milwaukee Ave
Lubbock, TX 79424
Phone (806) 687-4311

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180925000593 TX Practitioner - Physical Therapist in Private Practice 1951652353 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
McCombs and Associates Physical Therapy IncGroup PAC ID 8729145412, 9 clinicians

Practice addresses (Care Compare)

410 Ave G
Levelland, TX 79336-3719
Phone (806) 897-0540

9107 Milwaukee Ave
Lubbock, TX 79424-0921
Phone (806) 687-4311

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1307671TXMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
McCombs and Associates Physical Therapy, Inc. Physical Therapist CurrentSince Aug 6, 2018 Accepting new patients

Locations

410 Avenue G
Levelland, TX 79336
Phone (806) 897-0540

5217 82nd St
Unit 104
Lubbock, TX 79424
Phone (806) 687-4311

9107 Milwaukee Ave
Lubbock, TX 79424
Phone (806) 687-4311

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1533600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677715200000",
    "number": "1609355197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9107 MILWAUKEE AVE",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "79424",
            "telephone_number": "806-687-4311",
            "fax_number": "806-687-4313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 AVENUE G",
            "city": "LEVELLAND",
            "state": "TX",
            "postal_code": "793363719",
            "telephone_number": "806-897-0540",
            "fax_number": "806-897-0542"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9107 Milwaukee Ave",
            "address_purpose": "LOCATION",
            "city": "Lubbock",
            "state": "TX",
            "postal_code": "79424",
            "country_code": "US",
            "telephone_number": "806-687-4311",
            "fax_number": "806-687-4313",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LONG",
        "first_name": "CLARICE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-07",
        "last_updated": "2023-03-02",
        "certification_date": "2023-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1307671",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Levelland, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.