Jackie Withrow Wva Facility Operations LLC

Primary specialty

Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X

Legal business name

JACKIE WITHROW WVA FACILITY OPERATIONS LLC

Practice address

105 S Eisenhower Dr
Beckley, WV 25801-4929

Phone

(304) 256-6600

NPI assigned

Sep 10, 2025

Organization subpart

No

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

Authorized official

Name

Paul Pruitt

Title

Ceo

Phone

(616) 340-2707

Specialties & licenses 1

Addresses

Other names 1

• Majestic Care of Beckley Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Meagan M. Cobb, D.O.

  • Family Medicine Physician
  • Hinton, WV
  • NPI 1871937102
  NPD (past)
• Michael Anthony Kelly, MD

  • Emergency Medicine Physician
  • Beckley, WV
  • NPI 1245276955
  NPD (past)
• Mustafa Rahim, M.D.

  • Internal Medicine Physician
  • Beckley, WV
  • NPI 1831289891
  NPD (past)
• Jessica Sharp, FNP

  • Certified Registered Nurse Anesthetist
  • Beckley, WV
  • NPI 1295769578
  NPD (past)

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

{
    "created_epoch": "1757462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761177600000",
    "number": "1033090535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 S EISENHOWER DR",
            "city": "BECKLEY",
            "state": "WV",
            "postal_code": "258014929",
            "telephone_number": "304-256-6600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 S EISENHOWER DR",
            "city": "BECKLEY",
            "state": "WV",
            "postal_code": "258014929",
            "telephone_number": "304-256-6600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKIE WITHROW WVA FACILITY OPERATIONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-09-10",
        "last_updated": "2025-10-23",
        "certification_date": "2025-10-23",
        "status": "A",
        "authorized_official_last_name": "PRUITT",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "616-340-2707"
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Majestic Care of Beckley",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Helen Madeline Irvin
• Elias H Isaac, M.D
• J Kevin Dickenson MD
• Edna M Jaap
• Charles S Jacinto, PT
• Daun Leah Jackson, NURSE PRACTITIONER
• Juanima Jackson
• Mikia Jackson
• Farida Jafary
• Hassan Arshad Jafary, MD

• Nursing Facility/Intermediate Care Facility in Beckley, WV
• Providers in Beckley, WV by specialty
• Nursing Facility/Intermediate Care Facility in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.