Individual provider Active NPI

Chaz Daniel Williamson, DPT

  • Physical Therapist
  • Clive, IA
National Provider Identifier
1083846042
Registry record updated Apr 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
004424 Issued in IA
Practice address
1601 NW 114TH St Ste 347
Clive, IA 50325-7046
Phone
(515) 222-7350
Fax
(515) 222-7355
NPI assigned
Aug 10, 2009
Last updated
Apr 9, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2026

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 004424 IA Primary

Addresses

Primary practice location

1601 NW 114TH St Ste 347
Clive, IA 50325-7046

Mailing address

PO Box 674721
Dallas, TX 75267-4721
Phone (515) 643-2519

Other names 1

  • Dr. Charles Daniel Williamson Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090921000488 IA Practitioner - Physical Therapist in Private Practice 4183770910 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinics IncGroup PAC ID 7911810882, 441 clinicians

Practice addresses (Care Compare)

1601 NW 114TH St
Clive, IA 50325-7046

3310 SW 9TH St
Mercyone South Des Moines Physical Therapy
Des Moines, IA 50315-7647
Phone (515) 244-5005

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinics, Inc. Current Accepting new patients
Mercy Clinics, Inc. CurrentSince Oct 13, 2025 Accepting new patients
Mercy Clinics Inc Physical Therapist CurrentSince Oct 13, 2025 Accepting new patients
Personalized Therapy, Inc Physical Therapist PastSince Nov 10, 2015 Accepting new patients

Locations

1601 NW 114th St
Ste 155
Des Moines, IA 50325
Phone (515) 222-7350

1601 NW 114th St
Ste 347
Des Moines, IA 50325
Phone (515) 222-7350

3310 SW 9th St
Des Moines, IA 50315
Phone (515) 244-5005

Organizations & group practices 4

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": "1249862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775692800000",
    "number": "1083846042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 674721",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752674721",
            "telephone_number": "515-643-2519",
            "fax_number": "515-222-7350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 NW 114TH ST STE 347",
            "city": "CLIVE",
            "state": "IA",
            "postal_code": "503257046",
            "telephone_number": "515-222-7350",
            "fax_number": "515-222-7355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMSON",
        "first_name": "CHAZ",
        "middle_name": "DANIEL",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-08-10",
        "last_updated": "2026-04-09",
        "certification_date": "2026-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IA",
            "license": "004424",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHARLES",
            "last_name": "WILLIAMSON",
            "middle_name": "DANIEL",
            "prefix": "DR.",
            "credential": "DPT",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Clive, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2026; 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.