NPIMap

Williams Medical Group Practice, LLC

Organization Active NPI Rural Health Clinic/Center · Enid, OK

NPI 1508435330 · NPPES record last updated Feb 24, 2023

Key facts

NPI
1508435330
Entity type
Organization (NPI type 2)
Primary specialty
Rural Health Clinic/Center 261QR1300X
Legal business name
WILLIAMS MEDICAL GROUP PRACTICE, LLC
Practice address
220 S Van Buren St
Enid, OK 73703-5812
Phone
(580) 234-9355
NPI assigned
Jun 24, 2021
Organization subpart
No

Authorized official

Name
Grant Asay
Title
Ceo
Phone
(405) 445-1210

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

  • Tony R Hill, DO Emergency Medical Services (Emergency Medicine) Physician · Broken Arrow, OK · NPI 1295723245
    CMS ownership 5% OR GREATER DIRECT OWNERSHIP INTEREST · CORPORATE OFFICER · OPERATIONAL/MANAGERIAL CONTROL
  • Joseph Michael Moore, MD Internal Medicine Physician · Tulsa, OK · NPI 1104853142
    CMS ownership 5% OR GREATER DIRECT OWNERSHIP INTEREST

Corporate family (same tax ID) 35

Organizations that report the same tax identification number in the National Provider Directory.

View all 35

Facilities with the same owner 46

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 46

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
37D2069227Xpress Wellness Urgent Care
220 S Van Buren St, Enid, OK 73703		Certificate of waiverNov 19, 2027

Medicare participation

Medicare fee-for-service enrollment
Enrolled in OK

Rural health clinic certification: CCN 373890

Legal name
WILLIAMS MEDICAL GROUP PRACTICE, LLC
Doing business as
XPRESS WELLNESS URGENT CARE
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Sep 27, 2021
Last certification
May 16, 2024
Ownership / control type
1B
Organization structure
LLC · Proprietary
Incorporated
Dec 9, 2015 in KS
Enrollment address
220 S Van Buren St
Enid, OK 73703-5812

All disclosed owners & managing parties 5

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Joseph M Moore
Individual 		5% Or Greater Direct Ownership Interest
MD		 Aug 21, 2023 49%
Susan Paynter
Individual 		W-2 Managing Employee Oct 1, 2025
Joe W Alegre
Individual 		Corporate Officer
Chief Financial Officer		 Jul 1, 2025
Xpress Wellness LLC
Organization · Oklahoma City, OK
Management services company 		Operational/Managerial Control Jul 20, 2018
Tony Hill
Individual 		5% Or Greater Direct Ownership Interest
D.O./Cmo		 Jan 1, 2021 51%
Corporate Officer
Cmo		 Nov 1, 2022 100%
Operational/Managerial Control Nov 1, 2022

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20210708002152 OK Part a Provider - Rural Health Clinic 3375832157 Practice locations: Enid, OK

National Provider Directory

Tax ID family
Williams Medical Group Practice LLC (36 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193400000X SINGLE SPECIALTY GROUP		 207Q00000X
Rural Health Clinic/Center 261QR1300X Yes

Addresses

Primary practice location

220 S Van Buren St
Enid, OK 73703-5812

Mailing address

701 Cedar Lake Blvd Ste 120
Oklahoma City, OK 73114-7815
Phone (405) 445-1210

Other names

  • Xpress Wellness Urgent Care Doing business as

Other providers in Enid, OK

All providers in Enid, OK · Rural Health Clinic/Center in Oklahoma

Sources for this page

Verify at the official NPI Registry.