Individual provider Active NPI

William Tyler Clements, DO

  • Internal Medicine Physician
  • Knoxville, TN
National Provider Identifier
1033797352
Registry record updated Jun 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
5661 Issued in TN
Practice address
1901 Clinch Ave
Knoxville, TN 37916-2307
Phone
(865) 331-1111
NPI assigned
Mar 30, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X FL
Internal Medicine Physician 207R00000X 5661 TN Primary

Addresses

Primary practice location

1901 Clinch Ave
Knoxville, TN 37916-2307

Mailing address

1147 NW 64TH Ter
Gainesville, FL 32605-4218
Phone (352) 333-5980

Other practice location 1

7485 SW 17th Rd
Gainesville, FL 32607-1000
Phone (352) 333-5700

Other practice location 2

9352 Park West Blvd
Knoxville, TN 37923-4325
Phone (865) 373-1000

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20241017000611 TN Practitioner - Internal Medicine 0547792475

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3030 Northwest Expressway
Suite 1000
Oklahoma City, OK 73112-5468

PO Box
Suite 207829
Dallas, TX 75320-7829

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Statcare Inpatient LLC Internal Medicine CurrentSince Aug 1, 2024 Accepting new patients
Gainesville Physicians LLC CurrentSince Apr 1, 2021 Accepting new patients

Locations

7485 SW 17th Rd
Gainesville, FL 32607
Phone (352) 333-5700

9352 Park West Blvd
Knoxville, TN 37923
Phone (865) 373-1000

1901 Clinch Ave
Knoxville, TN 37916
Phone (865) 331-1111

Interoperability endpoints

  • Direct secure messaging: william.clements@hca5.eclinicaldirectplus.com

Organizations & group practices 2

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 3

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": "1617062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717977600000",
    "number": "1033797352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1147 NW 64TH TER",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326054218",
            "telephone_number": "352-333-5980",
            "fax_number": "352-333-5915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 CLINCH AVE",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379162307",
            "telephone_number": "865-331-1111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7485 SW 17th Rd",
            "address_purpose": "LOCATION",
            "city": "Gainesville",
            "state": "FL",
            "postal_code": "326071000",
            "country_code": "US",
            "telephone_number": "352-333-5700",
            "fax_number": "352-376-4975",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9352 Park West Blvd",
            "address_purpose": "LOCATION",
            "city": "Knoxville",
            "state": "TN",
            "postal_code": "379234325",
            "country_code": "US",
            "telephone_number": "865-373-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLEMENTS",
        "first_name": "WILLIAM",
        "middle_name": "TYLER",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-30",
        "last_updated": "2024-06-10",
        "certification_date": "2024-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "FL",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "5661",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

Verify at the official NPI Registry.