NPIMap

Individual provider Active NPI

Clifford G Williamson, MD

  • Emergency Medicine Physician
  • Johnson City, TN
National Provider Identifier
1154562304
Registry record updated Apr 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
52142 Issued in TN
Practice address
325 N State of Franklin Rd
Johnson City, TN 37604-6062
Phone
(423) 439-6283
NPI assigned
Mar 18, 2009
Last updated
Apr 29, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 0101282637 VA
Emergency Medicine Physician 207P00000X 52142 TN Primary

Addresses

Primary practice location

325 N State of Franklin Rd
Johnson City, TN 37604-6062

Mailing address

325 N State of Franklin Rd
Johnson City, TN 37604-6062
Phone (423) 439-6283

Other identifiers 1

IdentifierTypeStateIssuer
1154562304MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, VA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20150304002320 TN Practitioner - Emergency Medicine 9638495963 Reassigns benefits to 5 organizations
I20220304001553 VA Practitioner - General PracticePractitioner - Emergency Medicine 9638495963 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General PracticeAlso: Emergency Medicine
Education
East Tennessee State University Quillen College of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southeastern Physician Services PCGroup PAC ID 0042307852, 591 clinicians
Tri-Cities Regional Emergency Physicians, PCGroup PAC ID 3678859477, 118 clinicians

Practice addresses (Care Compare)

103 N St
Bristol, VA 24201-3201
Phone (276) 246-7240

113 Cassel Dr
Kingsport, TN 37660-3775
Phone (423) 246-7240

300 Med Tech Pkwy
Johnson City, TN 37604-2277
Phone (423) 302-1000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Merit-based Incentive Payment System (MIPS)

Final score
90.33 of 100Reported as group
Quality
83.8
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ipc Pac Healthcare Services of Tennessee PC CurrentSince Oct 19, 2020 Accepting new patients
Tri-Cities Regional Emergency Physicians, PC Emergency Medicine CurrentSince Apr 1, 2017 Accepting new patients
NV Pacs 2 LLC CurrentSince Sep 1, 2021 Accepting new patients
Southeastern Emergency Physicians LLC Emergency Medicine CurrentSince Jan 22, 2015 Accepting new patients
Encompass Health Rehabilitation Hospital of Kingsport LLC Past Accepting new patients

Locations

1643 NW 136th Ave
Ste 100
Sunrise, FL 33323
Phone (865) 500-1325

1224 Trotwood Ave
Columbia, TN 38401
Phone (931) 380-4072

1501 W Elk Ave
Elizabethton, TN 37643
Phone (423) 542-1300

880 S Mohawk Dr
Erwin, TN 37650
Phone (423) 743-7669

300 Med Tech Pkwy
Johnson City, TN 37604
Phone (423) 230-8200

400 N State of Franklin Rd
Johnson City, TN 37604
Phone (423) 431-1310

3916 Boyds Bridge Pike
Knoxville, TN 37914
Phone (865) 523-1500

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

103 North St
Bristol, VA 24201
Phone (276) 642-7901

Organizations & group practices 6

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.

Hospital & facility affiliations 7

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": "1237334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745884800000",
    "number": "1154562304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 N STATE OF FRANKLIN RD",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376046062",
            "telephone_number": "423-439-6283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 N STATE OF FRANKLIN RD",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376046062",
            "telephone_number": "423-439-6283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMSON",
        "first_name": "CLIFFORD",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-03-18",
        "last_updated": "2025-04-29",
        "certification_date": "2025-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "VA",
            "license": "0101282637",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TN",
            "license": "52142",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1154562304",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, TN

Sources for this page

Verify at the official NPI Registry.