JOHN CLYDE III CHILDRESS (M.D.) – Diagnostic Radiology Physician, NPI 1780902841
Diagnostic Radiology Physician
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Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,649 DIAGNOSTIC RADIOLOGY in MI
Provider Addresses for JOHN CLYDE III CHILDRESS (M.D.)
5900 BYRON CENTER AVE SW
WYOMING, MI 495199606
Phone: (616) 252-7159
Type: Mailing
700 E MOREHEAD ST
STE 300
CHARLOTTE, NC 282022788
Phone: (704) 334-7800
Type: Mailing
3299 Woodburn Rd Ste 110
Annandale, VA 220037310
Phone: (703) 849-9050
Type: Location
6211 Centreville Rd # 400M
Centreville, VA 201212641
Phone: (703) 204-4411
Type: Location
3300 Gallows Rd
Falls Church, VA 220423307
Phone: (703) 698-4444
Type: Location
1304 Fawcett Ave
Tacoma, WA 984021911
Phone: (253) 761-4200
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2025-09-30
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 5 Medicare enrollment records; no due dates published yet.
Enrollment records
5
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20150714000030 | I | Diagnostic Radiology | MI | TBD |
| I20160309002766 | I | Diagnostic Radiology | NC | TBD |
| I20160606000204 | I | Diagnostic Radiology | SC | TBD |
| I20250918000714 | I | Diagnostic Radiology | VA | TBD |
| I20250930003137 | I | Diagnostic Radiology | DC | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 71045 | X-ray of chest, 1 view | 481 | 452 | $0 |
| 74177 | Ct scan of abdomen and pelvis with contrast | 455 | 444 | $0 |
| 71260 | Ct scan of chest with contrast | 270 | 258 | $0 |
| 71046 | X-ray of chest, 2 views | 254 | 253 | $0 |
| 71275 | Ct scan of blood vessels of chest with contrast | 179 | 179 | $0 |
Insurance plans in this area (ZIP 49519)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| DIAGNOSTIC RADIOLOGY | MI | 71010 | X-ray of chest, 1 view, front | 547 | 483 |
| DIAGNOSTIC RADIOLOGY | MI | 71250 | CT scan chest | 105 | 103 |
| DIAGNOSTIC RADIOLOGY | MI | 73110 | X-ray of wrist, minimum of 3 views | 16 | 16 |
| DIAGNOSTIC RADIOLOGY | MI | 73630 | X-ray of foot, minimum of 3 views | 40 | 36 |
| DIAGNOSTIC RADIOLOGY | MI | 76942 | Ultrasonic guidance imaging supervision and interpretation for insertion of needle | 17 | 17 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Diagnostic Radiology | VA | |
| Diagnostic Radiology | VA | |
| Diagnostic Radiology | VA | |
| Diagnostic Radiology | CA | |
| Diagnostic Radiology | VA | |
| Diagnostic Radiology | VA | |
| Diagnostic Radiology | PA | |
| Diagnostic Radiology | CA | |
| Diagnostic Radiology | VA | |
| Diagnostic Radiology | VA |
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