Individual provider Active NPI

Clayton Womack, CPNP-AC

  • Critical Care Pediatric Nurse Practitioner
  • Flagstaff, AZ
National Provider Identifier
1912378118
Registry record updated Jun 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Pediatric Nurse PractitionerTaxonomy code 363LP0222X
License
323647 Issued in AZ
Practice address
1200 N Beaver St
Flagstaff, AZ 86001-3118
Phone
(928) 773-2112
NPI assigned
Oct 13, 2015
Last updated
Jun 11, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X AP129134 TX
Pediatric Nurse Practitioner 363LP0200X AP129134 TX
Critical Care Pediatric Nurse Practitioner 363LP0222X 323647 AZ Primary

Addresses

Primary practice location

1200 N Beaver St
Flagstaff, AZ 86001-3118

Mailing address

5219 City Bank Pkwy Ste 35
Lubbock, TX 79407-3545
Phone (806) 761-0333

Other practice location 1

800 E Dawson St
Tyler, TX 75701-2036
Phone (903) 606-5956

Other practice location 2

602 Indiana Ave
Lubbock, TX 79415-3364
Phone (806) 775-8828

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, AZ2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20160329000193 TX Practitioner - Nurse Practitioner 1254638737 Reassigns benefits to 4 organizations
I20250617002989 AZ Practitioner - Nurse Practitioner 1254638737 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Tech University Health Sciences Center Lubbock CurrentSince Dec 31, 2019 Accepting new patients
Texas Tech University Health Sciences Center Lubbock Current Accepting new patients
Cook Children's Physician Network CurrentSince Aug 26, 2024 Accepting new patients
Christus Trinity Clinic Texas CurrentSince Jan 6, 2026 Accepting new patients
Sound Physicians Emergency Medicine of Texas PLLC Nurse Practitioner CurrentSince Jan 1, 2025 Accepting new patients
Cook Children's Physician Network Current Accepting new patients
Christus Trinity Clinic Texas CurrentSince Jan 6, 2026 Accepting new patients
Texas Tech University Health Sciences Center Lubbock CurrentSince Dec 31, 2019 Accepting new patients

Locations

801 7th Ave
Ft Worth, TX 76104
Phone (682) 885-4054

1275 Marvin Hancock Dr
Jasper, TX 75951
Phone (409) 384-1951

3502 9th St
Ste 130
Lubbock, TX 79415
Phone (806) 743-1188

3601 4th St
Lubbock, TX 79430
Phone (806) 743-1000

3615 19th St
Lubbock, TX 79410
Phone (806) 725-0000

4002 24th St
Lubbock, TX 79410
Phone (806) 725-0000

4102 24th St
Ste 201
Lubbock, TX 79410
Phone (806) 725-4676

602 Indiana Ave
Lubbock, TX 79415
Phone (806) 743-2898

3600 Gates Blvd
Port Arthur, TX 77642
Phone (409) 985-7431

630 S Fleishel Ave
Tyler, TX 75701
Phone (903) 510-8888

800 E Dawson St
Tyler, TX 75701
Phone (903) 531-5018

136 El Chico Trl
Ste 102
Willow Park, TX 76087
Phone (817) 441-5412

Interoperability endpoints

  • Direct secure messaging: clayton.womack@direct.myhealthep.org

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1444694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781136000000",
    "number": "1912378118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5219 CITY BANK PKWY STE 35",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794073545",
            "telephone_number": "806-761-0333",
            "fax_number": "806-782-0097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 N BEAVER ST",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860013118",
            "telephone_number": "928-773-2112"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "800 E Dawson St",
            "address_purpose": "LOCATION",
            "city": "Tyler",
            "state": "TX",
            "postal_code": "757012036",
            "country_code": "US",
            "telephone_number": "903-606-5956",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "602 Indiana Ave",
            "address_purpose": "LOCATION",
            "city": "Lubbock",
            "state": "TX",
            "postal_code": "794153364",
            "country_code": "US",
            "telephone_number": "806-775-8828",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WOMACK",
        "first_name": "CLAYTON",
        "credential": "CPNP-AC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-10-13",
        "last_updated": "2026-06-11",
        "certification_date": "2026-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "AP129134",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "AP129134",
            "primary": false
        },
        {
            "code": "363LP0222X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics, Critical Care",
            "state": "AZ",
            "license": "323647",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flagstaff, AZ

Sources for this page

Verify at the official NPI Registry.