Clayton Matthew Wilson, A.T., C., O.T.C.

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

087 Issued in WY

Practice address

4140 Centennial Hills Blvd
Casper, WY 82609-3265

Phone

(307) 265-7205

Fax

(307) 235-6262

NPI assigned

Mar 27, 2006

Last updated

Apr 12, 2016By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1143417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460419200000",
    "number": "1659331239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4140 CENTENNIAL HILLS BLVD",
            "city": "CASPER",
            "state": "WY",
            "postal_code": "826093265",
            "telephone_number": "307-265-7205",
            "fax_number": "307-235-6262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4140 CENTENNIAL HILLS BLVD",
            "city": "CASPER",
            "state": "WY",
            "postal_code": "826093265",
            "telephone_number": "307-265-7205",
            "fax_number": "307-235-6262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "CLAYTON",
        "middle_name": "MATTHEW",
        "name_prefix": "Mr.",
        "credential": "A.T., C., O.T.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-27",
        "last_updated": "2016-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "WY",
            "license": "087",
            "primary": true
        },
        {
            "code": "246ZX2200X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Orthopedic Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CERTIFIED ORTHOPEDIC TECHNOLOGIST",
            "identifier": "16-0200",
            "state": "WY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CERTIFIED ATHLETIC TRAINER",
            "identifier": "087",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mary Ellen Williams, NP-C
• Sharil L. Williams, M.S., LPC
• Katherine Willis
• Floyd Dale Wilmes II, OTRL
• Caleb Despain Wilson, M.D.
• Gail Marie Wilson, RN, BSN
• Joanna Lee Wilson, PNP
• Martha Jo Wilson, FNP-C
• Nicole Marie Wilson
• Whitney Cailin Wilson, LPC

• Athletic Trainer in Casper, WY
• Providers in Casper, WY by specialty
• Athletic Trainer in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.