Individual provider Active NPI

Lisa Beth Williford, MD

  • Emergency Medicine Physician
  • Fort Worth, TX
National Provider Identifier
1346477767
Registry record updated Oct 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
P2401 Issued in TX
Practice address
6451 Brentwood Stair Rd Ste 200
Fort Worth, TX 76112-3200
Phone
(817) 496-9700
NPI assigned
Jun 11, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 5, 2022

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 156985 NC
Emergency Medicine Physician 207P00000X P2401 TX Primary

Addresses

Primary practice location

6451 Brentwood Stair Rd Ste 200
Fort Worth, TX 76112-3200

Mailing address

6451 Brentwood Stair Rd Ste 200
Fort Worth, TX 76112-3200
Phone (817) 496-9700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20120821000487 TX Practitioner - Emergency Medicine 0446422570 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
P2401TXMDEmergency Medicine Physician
156985NCMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Medicine Resources, LLP Emergency Medicine CurrentSince Apr 15, 2013 Accepting new patients
Texas Physician Resources, LLP Emergency Medicine CurrentSince Feb 1, 2013 Accepting new patients
Neuse River Emergency Physicians Emergency Medicine Past Accepting new patients

Locations

1105 Central Expy N
Allen, TX 75013
Phone (972) 747-4313

201 Walls Dr
Cleburne, TX 76033
Phone (817) 556-5587

1441 N Beckley Ave
Dallas, TX 75203
Phone (214) 712-2429

6451 Brentwood Stair Rd
Ste 200
Ft Worth, TX 76112
Phone (817) 496-9700

1301 Pennsylvania Ave
Ft Worth, TX 76104
Phone (817) 250-2000

2700 E Broad St
Mansfield, TX 76063
Phone (682) 242-2000

Organizations & group practices 3

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1244678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664928000000",
    "number": "1346477767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6451 BRENTWOOD STAIR RD STE 200",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761123200",
            "telephone_number": "817-496-9700",
            "fax_number": "919-966-3049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6451 BRENTWOOD STAIR RD STE 200",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761123200",
            "telephone_number": "817-496-9700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIFORD",
        "first_name": "LISA",
        "middle_name": "BETH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-06-11",
        "last_updated": "2022-10-05",
        "certification_date": "2022-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NC",
            "license": "156985",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "P2401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.