NPIMap

Individual provider Active NPI

Clinton Williamson, MD

  • Diagnostic Radiology Physician
  • Oklahoma City, OK
National Provider Identifier
1972711422
Registry record updated Jun 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
25121 Issued in OK
Practice address
3433 NW 56TH St, Suite C-40
Oklahoma City, OK 73112-4455
Phone
(405) 945-4741
Fax
(888) 972-5320
NPI assigned
May 18, 2007
Last updated
Jun 14, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 25121 OK Primary

Addresses

Primary practice location

3433 NW 56TH St, Suite C-40
Oklahoma City, OK 73112-4455

Mailing address

3433 NW 56TH St, Suite C-40
Oklahoma City, OK 73112-4455
Phone (405) 945-4741

Other identifiers 3

IdentifierTypeStateIssuer
P00840510OtherOKMEDICARE RAILROAD
200246060AMedicaidOK
P00860908OtherOKMEDICARE RAILROAD MPI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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
I20090806000679 OK Practitioner - Diagnostic Radiology 3779636832 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Emory University School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Radiology Associates LLCGroup PAC ID 4082692496, 20 clinicians

Practice addresses (Care Compare)

1201 Health Ctr Pkwy
Yukon, OK 73099-6381
Phone (405) 717-6800

3300 NW Expressway
Oklahoma City, OK 73112-4418
Phone (405) 949-3011

3524 NW 56TH St
Oklahoma City, OK 73112-4518
Phone (405) 606-6937

3525 NW 56TH St
Suite 100C
Oklahoma City, OK 73112-4549
Phone (405) 945-0045

4801 Integris Pkwy
Edmond, OK 73034-8864
Phone (405) 657-3000

5501 N Portland Ave
Oklahoma City, OK 73112-2074
Phone (405) 604-6000

5911 W Memorial Rd
Oklahoma City, OK 73142-2015
Phone (405) 773-6400

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
65.61 of 100Reported as group
Quality
55.21
Improvement activities
40
Cost
67.5

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
25121OKMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Radiology Associates LLC Diagnostic Radiology CurrentSince Jul 1, 2010 Accepting new patients
Integris Prohealth Inc CurrentSince Oct 4, 2017 Accepting new patients
Jackson County Memorial Hospital Authority Past Accepting new patients
Integris Ambulatory Care Corporation Past Accepting new patients

Locations

3330 NW 56th St
Ste 206
Oklahoma City, OK 73112
Phone (405) 945-4710

3433 NW 56th St
Ste C10
Oklahoma City, OK 73112
Phone (405) 945-4740

3433 NW 56th St
Ste C40
Oklahoma City, OK 73112

5501 N Portland Ave
Oklahoma City, OK 73112
Phone (405) 604-6000

Dept 960591
Oklahoma City, OK 73196

Organizations & group practices 4

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 11

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

NPI Registry JSON

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

{
    "created_epoch": "1179446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623628800000",
    "number": "1972711422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3433 NW 56TH ST, SUITE C-40",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731124455",
            "telephone_number": "405-945-4741",
            "fax_number": "888-972-5320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3433 NW 56TH ST, SUITE C-40",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731124455",
            "telephone_number": "405-945-4741",
            "fax_number": "888-972-5320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMSON",
        "first_name": "CLINTON",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-18",
        "last_updated": "2021-06-14",
        "certification_date": "2021-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "OK",
            "license": "25121",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00840510",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200246060A",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD MPI",
            "identifier": "P00860908",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.