NPIMap

Williams Medical Group Practice, LLC

Organization Active NPI Rural Health Clinic/Center · Muskogee, OK

NPI 1003486846 · NPPES record last updated Jan 23, 2023

Key facts

NPI
1003486846
Entity type
Organization (NPI type 2)
Primary specialty
Rural Health Clinic/Center 261QR1300X
Legal business name
WILLIAMS MEDICAL GROUP PRACTICE, LLC
Practice address
2525 Chandler Rd
Muskogee, OK 74403-5088
Phone
(918) 681-7533
NPI assigned
Jun 24, 2021
Organization subpart
No

Authorized official

Name
Grant Asay
Title
Ceo
Phone
(405) 445-1210

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

  • Tony R Hill, DO Emergency Medical Services (Emergency Medicine) Physician · Broken Arrow, OK · NPI 1295723245
    CMS ownership 5% OR GREATER DIRECT OWNERSHIP INTEREST · CORPORATE OFFICER · W-2 MANAGING EMPLOYEE
  • Joseph Michael Moore, MD Internal Medicine Physician · Tulsa, OK · NPI 1104853142
    CMS ownership 5% OR GREATER DIRECT OWNERSHIP INTEREST

Corporate family (same tax ID) 35

Organizations that report the same tax identification number in the National Provider Directory.

View all 35

Facilities with the same owner 46

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 46

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
37D2083240Xpress Wellness Urgent Care
2525 Chandler Rd, Muskogee, OK 74403		Certificate of waiverSep 1, 2026

Medicare participation

Medicare fee-for-service enrollment
Enrolled in OK

Rural health clinic certification: CCN 373888

Legal name
WILLIAMS MEDICAL GROUP PRACTICE, LLC
Doing business as
XPRESS WELLNESS URGENT CARE
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Sep 24, 2021
Last certification
Jul 25, 2024
Ownership / control type
1B
Organization structure
LLC · Proprietary
Incorporated
Dec 9, 2015 in KS
Enrollment address
2525 Chandler Rd
Muskogee, OK 74403-5088

All disclosed owners & managing parties 4

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Grant B Asay
Individual 		Corporate Officer
Ceo		 Feb 11, 2019
Joseph M Moore
Individual 		5% Or Greater Direct Ownership Interest
MD		 Aug 21, 2023 49%
Xpress Wellness LLC
Organization · Oklahoma City, OK
Management services company 		Operational/Managerial Control Mar 1, 2019
Tony Hill
Individual 		5% Or Greater Direct Ownership Interest
D.O./Cmo		 Jan 1, 2021 51%
Corporate Officer
Cmo		 Nov 1, 2022
W-2 Managing Employee
Cmo		 Nov 1, 2022 100%

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20210712003243 OK Part a Provider - Rural Health Clinic 3375832157 Practice locations: Muskogee, OK

National Provider Directory

Tax ID family
Williams Medical Group Practice LLC (36 organizations share this tax ID)

Locations

445 W 15th St
Liberal, KS 67901
Phone (620) 417-9012

416 N Main St
Altus, OK 73521
Phone (580) 379-0325

901 W Main St
Durant, OK 74701
Phone (580) 634-2931

12190 S Waco Ave
Ste C
Glenpool, OK 74033
Phone (918) 936-2882

949 E Taft Ave
Sapulpa, OK 74066
Phone (918) 224-6079

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193400000X SINGLE SPECIALTY GROUP		 207Q00000X
Rural Health Clinic/Center 261QR1300X Yes

Addresses

Primary practice location

2525 Chandler Rd
Muskogee, OK 74403-5088

Mailing address

701 Cedar Lake Blvd Ste 120
Oklahoma City, OK 73114-7815
Phone (405) 445-1210

Other names

  • Xpress Wellness Urgent Care Doing business as

Other providers in Muskogee, OK

All providers in Muskogee, OK · Rural Health Clinic/Center in Oklahoma

Sources for this page

Verify at the official NPI Registry.