NPIMap

Individual provider Active NPI

Clifford C Wilson, ANP

  • Psychiatric/Mental Health Nurse Practitioner
  • Anchorage, AK
National Provider Identifier
1457503823
Registry record updated Feb 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
NURU1055 Issued in AK
Practice address
4341 Tudor Centre Dr Ste 300
Anchorage, AK 99508-5904
Phone
(907) 729-2500
NPI assigned
Oct 16, 2008
Last updated
Feb 24, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X NURU1055 AK Primary

Addresses

Primary practice location

4341 Tudor Centre Dr Ste 300
Anchorage, AK 99508-5904

Mailing address

7033 E Tudor Rd
Anchorage, AK 99507-1262
Phone (907) 729-9989

Other practice location 1

4320 Diplomacy Dr
Suite 1500
Anchorage, AK 99508-5925
Phone (907) 729-2500

Other identifiers 1

IdentifierTypeStateIssuer
NP0064MedicaidAK

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090302000519 TX Practitioner - Nurse Practitioner 5890851737 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Yale University School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southcentral FoundationGroup PAC ID 5496663627, 168 clinicians

Practice addresses (Care Compare)

1001 S Knik Goose Bay Rd
Wasilla, AK 99654-8083

4341 Tudor Centre Dr
Anchorage, AK 99508-5904

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.77 of 100Reported as group
Quality
76.11
Promoting interoperability
100
Improvement activities
40
Cost
79.79

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bristol Bay Area Health Corporation Current Accepting new patients
Alaska Native Tribal Health Consortium CurrentSince Apr 1, 2019 Accepting new patients
Southcentral Foundation CurrentSince Feb 10, 2012 Accepting new patients
Bristol Bay Area Health Corporation CurrentSince Jun 6, 2013 Accepting new patients
Southcentral Foundation Current Accepting new patients
Bristol Bay Area Health Corporation CurrentSince Jun 6, 2013 Accepting new patients
Southcentral Foundation PastSince Sep 5, 2023 Accepting new patients
Southcentral Foundation Past Accepting new patients
Southcentral Foundation Past Accepting new patients
Southcentral Foundation PastSince Jul 28, 2019 Accepting new patients

Locations

4315 Diplomacy Dr
Anchorage, AK 99508
Phone (907) 729-1729

4320 Diplomacy Dr
Anchorage, AK 99508
Phone (907) 729-0000

4320 Diplomacy Dr
Ste 1500
Anchorage, AK 99508
Phone 90772925003

4501 Diplomacy Dr
Anchorage, AK 99508
Phone (800) 478-3343

7033 E Tudor Rd
Anchorage, AK 99507
Phone (907) 729-0000

Interoperability endpoints

  • Direct secure messaging: cwilson@direct.scf.cc

Organizations & group practices 10

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 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1224115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740355200000",
    "number": "1457503823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7033 E TUDOR RD",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995071262",
            "telephone_number": "907-729-9989",
            "fax_number": "907-729-5180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4341 TUDOR CENTRE DR STE 300",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995085904",
            "telephone_number": "907-729-2500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4320 Diplomacy Dr",
            "address_2": "Suite 1500",
            "address_purpose": "LOCATION",
            "city": "Anchorage",
            "state": "AK",
            "postal_code": "995085925",
            "country_code": "US",
            "telephone_number": "907-729-2500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "CLIFFORD",
        "middle_name": "C",
        "credential": "ANP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-10-16",
        "last_updated": "2025-02-24",
        "certification_date": "2025-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AK",
            "license": "NURU1055",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP0064",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

Verify at the official NPI Registry.