NPIMap

Organization Active NPI

Williamson Memorial, Inc.

  • General Acute Care Hospital
  • Williamson, WV
National Provider Identifier
1013521228
Registry record updated Nov 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
Legal business name
WILLIAMSON MEMORIAL, INC.
Practice address
859 Alderson St
Williamson, WV 25661-3215
Phone
(304) 236-5902
NPI assigned
Sep 4, 2020
Last updated
Nov 11, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2024

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

Authorized official

Name
Crystal Branham
Title
Cfo
Phone
(304) 236-5902

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X Primary

Addresses

Primary practice location

859 Alderson St
Williamson, WV 25661-3215

Mailing address

PO Box 2080
Williamson, WV 25661-2080

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20201124002158 WV Part B Supplier - Clinic/Group Practice 7618388554 Receives reassigned benefits from 16 practitioners
1 other NPI on this enrollment
Practice locations: Williamson, WV
O20240314003797 WV Part A Provider - Hospital 7618388554 Practice locations: Williamson, WV

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1013521228. Details of each certification follow.

Hospital certification: CCN 510094

Legal name
WILLIAMSON MEMORIAL INC
Doing business as
WILLIAMSON HEALTH & WELLNESS CENTER- BEHAVIORAL MEDICINE CLINIC
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Aug 28, 2024
Last certification
Aug 28, 2024
Beds
76
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
in WV
Enrollment address
859 Alderson St
Williamson, WV 25661-3215
Main/Primary Hospital Location
Hospital subgroups
General, Acute care

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Hospital

Medicare Care Compare
Listed as
Williamson Memorial IncCCN 510094 · All quality measures
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
No

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 4

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Timothy Hatfield Individual Corporate Officer Jan 22, 2024 100%
W-2 Managing EmployeeCeo Jan 22, 2024 100%
Christopher Donovan Beckett Individual Corporate OfficerCeo May 1, 2025 100%
W-2 Managing EmployeeCeo May 1, 2025 100%
David Jewell Individual Corporate OfficerCfo Jan 22, 2024 100%
W-2 Managing EmployeeCfo Jan 22, 2024 100%
Williamson Health & Wellness Center Inc Organization, Williamson, WV Corporation, Non-profit 5% Or Greater Direct Ownership Interest May 31, 2020 100%

Owners & managing parties with NPI records 16

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

View all 16

Facilities with the same owner 2

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 16

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 16

Affiliated clinicians 3

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1599177600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731283200000",
    "number": "1013521228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2080",
            "city": "WILLIAMSON",
            "state": "WV",
            "postal_code": "256612080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "859 ALDERSON ST",
            "city": "WILLIAMSON",
            "state": "WV",
            "postal_code": "256613215",
            "telephone_number": "304-236-5902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIAMSON MEMORIAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-04",
        "last_updated": "2024-11-11",
        "certification_date": "2024-11-11",
        "status": "A",
        "authorized_official_last_name": "BRANHAM",
        "authorized_official_first_name": "CRYSTAL",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "304-236-5902"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamson, WV

Sources for this page

Verify at the official NPI Registry.