Individual provider Active NPI

Willie Gene McClure III, MD

  • Diagnostic Radiology Physician
  • Nellis AFB, NV
National Provider Identifier
1225699903
Registry record updated Jul 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
33650 Issued in NE
Practice address
4700 Las Vegas Blvd N
Nellis AFB, NV 89191-6600
Phone
(702) 653-2273
NPI assigned
Jun 24, 2019
Last updated
Jul 9, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 33650 NE Primary

Addresses

Primary practice location

4700 Las Vegas Blvd N
Nellis AFB, NV 89191-6600

Mailing address

4700 Las Vegas Blvd N
Nellis AFB, NV 89191-6600
Phone (702) 653-2273

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
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
I20251104004476 NV Practitioner - Diagnostic Radiology 5698265072 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Uniformed Services Uhs Fe Hebert School of Med, 2019
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4700 Las Vegas Blvd N
Nellis AFB, NV 89191-6600

5423 Reno Corporate Dr
Reno, NV 89511-2250

PO Box
Las Vegas, NV 89193

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
33650NEMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
John a Shields MD and Steven a Schiff MD a Professional Corporation CurrentSince Oct 15, 2025 Accepting new patients
River Bend Imaging LLC PastSince Nov 1, 2025 Accepting new patients

Locations

5423 Reno Corporate Dr
Reno, NV 89511
Phone (775) 329-0222

5470 Reno Corporate Dr
Reno, NV 89511
Phone (775) 329-0873

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, 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": "1561334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752019200000",
    "number": "1225699903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4700 LAS VEGAS BLVD N",
            "city": "NELLIS AFB",
            "state": "NV",
            "postal_code": "891916600",
            "telephone_number": "702-653-2273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 LAS VEGAS BLVD N",
            "city": "NELLIS AFB",
            "state": "NV",
            "postal_code": "891916600",
            "telephone_number": "702-653-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCLURE",
        "first_name": "WILLIE",
        "middle_name": "GENE",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-24",
        "last_updated": "2025-07-09",
        "certification_date": "2025-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NE",
            "license": "33650",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nellis AFB, NV

Sources for this page

Verify at the official NPI Registry.