STATE OF WEST VIRGINIA (NPI# 1619969706) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619969706 |
| Entity Type | Organization |
| Organization Name | STATE OF WEST VIRGINIA |
| Other Organization Name | JACKIE WITHROW HOSPITAL |
| Practice Address |
105 S Eisenhower Dr Beckley WV 25801-4929 |
| Practice Telephone | 3042566600 |
| Practice Fax Number | 3042506554 |
| Mailing Telephone | 3042566600 |
| Mailing Fax Number | 3042506554 |
| Enumeration Date | 2005-08-16 |
| Last Update Date | 2010-02-05 |
| Authorized Official Name | MS. CARLA JEAN PARENT (CHIEF FINANCIAL OFFICER) |
| Authorized Official Telephone | 3042566600 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 313M00000X | Nursing Facility/Intermediate Care Facility | 181 | WV | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WV | 0003978000 | 05 |
| Other Name | Type Code |
|---|---|
| Jackie Withrow Hospital | Other Name - Individual/Organization |
| Street Address |
105 S EISENHOWER DR |
| City | BECKLEY |
| State | WV |
| Zip Code | 25801-4929 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952639064 | Erykah Yvonne Starks | Licensed Practical Nurse | 105 S Eisenhower Dr, Beckley, WV 25801-4929 | 2009-12-01 |
| 1730128760 | Health Care Alliance, Inc. | Hospitalist | 105 S Eisenhower Dr, Beckley, WV 25801-4929 | 2006-06-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144835190 | Misty Dawn Chambers | Psychologist | 154 Lagoon Way, Beckley, USA 25801 | 2020-09-15 |
| 1912511437 | Katherine Lynne Mcghee | Technician | 120 Schlager Dr., Beckley, WV 25801 | 2020-09-02 |
| 1255942421 | Tyesha Burger | Technician | 442 Industrial Dr, Beckley, WV 25801 | 2020-08-12 |
| 1053920553 | Angela Sanches | Case Manager/Care Coordinator | 134 Gooseberry Ln, Beckley, WV 25801 | 2020-07-30 |
| 1871119933 | Tiffani Michelle Dale | Counselor | 111 Coral Court, Apt 5, Beckley, WV 25801 | 2020-06-24 |
| 1679046049 | Liberty Dental Centers | Dentist | 102 Galleria Plaza, Beckley, WV 25801 | 2019-01-08 |
| 1952884942 | Susan Rae Rash | Nurse Practitioner | 250 Stanaford Rd Ste 203, Beckley, WV 25801 | 2018-09-14 |
| 1689169039 | Megan Rae Walker | Dentist | 3153 Robert C. Byrd Drive, Beckley, WV 25801 | 2018-06-28 |
| 1104318625 | Mountain State Vascular, Inc. | Surgery | 121 George Street, Beckley, WV 25801 | 2018-05-31 |
| 1356841100 | Harper Road Treatment Center LLC | Family Medicine | 1802 Harper Rd Ste 202, Beckley, WV 25801 | 2018-02-19 |
| Find all providers in zip 25801 | ||||
| Taxonomy Code | 313M00000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Nursing Facility/Intermediate Care Facility |
| An institution (or a distinct part of an institution) which- (1) is primarily engaged in providing to residents- (A) skilled nursing care and related services for residents who require medical or nursing care, (B) rehabilitation services for the rehabilitation of injured, disabled, or sick persons, or, on a regular basis, health-related care and services to individuals who because of their mental or physical condition require care and services (above the level of room and board) which can be made available to them only through institutional facilities, and is not primarily for the care and treatment of mental diseases; (2) has in effect a transfer agreement with one or more hospitals. |
| Notes: Source: Paraphrased from Section 1919 (a) of the Social Security Act. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841247376 | Sunbridge Beckley Health Care LLC | Nursing Facility/Intermediate Care Facility | 405 Stanaford Rd, Beckley, WV 25801-3143 | 2006-05-30 |
| 1285040683 | Riparian Investments LLC | Nursing Facility/Intermediate Care Facility | 100 Heartland Dr, Beckley, WV 25801-2655 | 2014-07-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336524586 | Bridgeport Health Care Center, LLC | Nursing Facility/Intermediate Care Facility | Rt 4 Box 17, Bridgeport, WV 26330-9509 | 2015-07-29 |
| 1629453766 | Rainelle Center LLC | Nursing Facility/Intermediate Care Facility | 276 Pennsylvania Ave, Rainelle, WV 25962-1177 | 2015-07-29 |
| 1558754507 | Lewisburg Center LLC | Nursing Facility/Intermediate Care Facility | 979 Rocky Hill Rd, Ronceverte, WV 24970-8028 | 2015-03-16 |
| 1467845412 | Wellsburg Center LLC | Nursing Facility/Intermediate Care Facility | 70 Valley Haven Dr, Wellsburg, WV 26070-2625 | 2015-03-16 |
| 1508254319 | Mary Bird | Nursing Facility/Intermediate Care Facility | 590 North Poplar Fork Rd, Hurricane, WV 25526-9434 | 2014-12-31 |
| 1952536377 | Springfield Center LLC | Nursing Facility/Intermediate Care Facility | 10797 Seneca Trl S, Lindside, WV 24951-7345 | 2009-05-29 |
| 1720281975 | Pleasant Valley Nursing and Rehabilitation Center, Inc. | Nursing Facility/Intermediate Care Facility | 640 Sandhill Rd, Pt Pleasant, WV 25550-2163 | 2007-06-06 |
| 1255427415 | Bridgeport Senior Living, LLC | Nursing Facility/Intermediate Care Facility | Rr 4 Box 17, Bridgeport, WV 26330-9509 | 2006-10-05 |
| 1194816025 | Lakin Hospital | Nursing Facility/Intermediate Care Facility | 1 Bateman Cir, Lakin, WV 25287-9784 | 2006-09-27 |
| 1922100031 | Morgantown Healthcare Corp | Nursing Facility/Intermediate Care Facility | 30 Vandervort Dr, Morgantown, WV 26505 | 2006-09-01 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.