NPIMap

Organization Active NPI

Williams Medical Group Practice, LLC

  • Rural Health Clinic/Center
  • Edmond, OK
National Provider Identifier
1629944459
Registry record updated Oct 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
WILLIAMS MEDICAL GROUP PRACTICE, LLC
Practice address
4475 Sunrise Blvd
Edmond, OK 73034
Phone
(405) 445-1210
NPI assigned
Oct 17, 2025
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Steven Hull
Title
Coo
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.

Facilities with the same owner 46

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

View all 46

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
37D2335165Xpress Wellness Urgent Care4475 E Waterloo Road, Edmond, OK 73034Certificate of waiverDec 7, 2027

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK

Rural health clinic certification: CCN 373920

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
Apr 20, 2026
Last certification
Apr 20, 2026
Ownership / control type
1B
Organization structure
LLCProprietary
Enrollment address
4475 E Waterloo Rd
Edmond, OK 73034-9200

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251126001893 OK Part A Provider - Rural Health Clinic 3375832157 Practice locations: Edmond, OK

All disclosed owners & managing parties 5

Medicare enrollment files

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 Aug 21, 2023
Susan Paynter Individual W-2 Managing Employee Oct 1, 2025 100%
Joe W Alegre Individual Corporate OfficerChief Financial Officer Jul 1, 2025 100%
Xpress Wellness LLC Organization, Oklahoma City, OK LLC Operational/Managerial Control Jul 20, 2018 100%
Tony Hill Individual 5% Or Greater Direct Ownership InterestDirect Owner Aug 21, 2023 51%
Corporate OfficerChief Medical Officer Nov 1, 2022 100%

National Provider Directory

National Provider Directory
Tax ID family
Williams Medical Group Practice LLC36 organizations share this tax ID, including this one

Other organizations with this tax ID 35

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

View all 35

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary

Addresses

NPPES NPI Registry

Primary practice location

4475 Sunrise Blvd
Edmond, OK 73034

Mailing address

PO Box 95469
Grapevine, TX 76099-9700

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Oct 17, 2025.

{
    "created_epoch": "1760659200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1760659200000",
    "number": "1629944459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 95469",
            "city": "GRAPEVINE",
            "state": "TX",
            "postal_code": "760999700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4475 SUNRISE BLVD",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "73034",
            "telephone_number": "405-445-1210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIAMS MEDICAL GROUP PRACTICE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-10-17",
        "last_updated": "2025-10-17",
        "certification_date": "2025-10-01",
        "status": "A",
        "authorized_official_last_name": "HULL",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "405-445-1210"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edmond, OK

Sources for this page

Verify at the official NPI Registry.