Angela Long, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

60727-20 Issued in WI

Practice address

7201 Green Bay Rd Ste D
Kenosha, WI 53142-3532

Phone

(262) 842-0149

Fax

(262) 764-1986

NPI assigned

Jul 26, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Dr. Angela Richardson Former name

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Cleanslate Medical Group of Wisconsin SCGroup PAC ID 4284905134, 26 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Cleanslate Medical Group of Wisconsin, SC

  • Addiction Medicine (Internal Medicine) Physician
  • Glendale, WI
  • NPI 1518404854
  Medicare reassignment Care Compare group NPD
• Behavioral Wellness Inc

  • Community Health Worker
  • Blue Island, IL
  • NPI 1235373325
  NPD (past)
• Fastrac Medical, P.C.

  • Emergency Medicine Physician
  • Joliet, IL
  • NPI 1659517597
  NPD (past)
• Physicians Immediate Care North Chicago LLC

  • Urgent Care Clinic/Center
  • Chicago, IL
  • NPI 1205814118
  NPD (past)

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

{
    "created_epoch": "1185408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758585600000",
    "number": "1689864761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7201 GREEN BAY RD STE D",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531423532",
            "telephone_number": "262-842-0149",
            "fax_number": "262-764-1986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7201 GREEN BAY RD STE D",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531423532",
            "telephone_number": "262-842-0149",
            "fax_number": "262-764-1986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONG",
        "first_name": "ANGELA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-26",
        "last_updated": "2025-09-23",
        "certification_date": "2025-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "60727-20",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036-109214",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANGELA",
            "last_name": "RICHARDSON",
            "prefix": "DR.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Lockhart Chiropractic
• Anthony G Locurto
• Jessie Michelle Lohr
• Nakia London, BSN
• Kelsey Loney, SLP
• Lauren McKenzie Long
• Tabitha Marie Long
• John M Lopez, M.D.
• Taneeka Lopez
• Jacqueline Lord, DC

• Family Medicine Physician in Kenosha, WI
• Providers in Kenosha, WI by specialty
• Family Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2025; 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.

Verify at the official NPI Registry.