NPIMap

Organization Active NPI

Williamson Health & Wellness Center Inc

Doing business as Williamson Health & Wellness Center- Matewan PK-8

  • Federally Qualified Health Center (FQHC)
  • Matewan, WV
National Provider Identifier
1386360683
Registry record updated Oct 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
WILLIAMSON HEALTH & WELLNESS CENTER INC
Doing business as
Williamson Health & Wellness Center- Matewan PK-8
Practice address
104 Chambers St.
Matewan, WV 25678
Phone
(304) 426-8569
NPI assigned
Oct 18, 2022
Last updated
Oct 18, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
WILLIAMSON HEALTH & WELLNESS CENTER INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 18, 2022

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

Authorized official

Name
Christopher Donovan Beckett, DO
Title
Ceo
Phone
(304) 236-5902

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

104 Chambers St.
Matewan, WV 25678

Mailing address

PO Box 2080
Williamson, WV 25661-2080
Phone (304) 236-5902

Other names 1

  • Williamson Health & Wellness Center- Matewan PK-8 Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20140521000620 WV Part B Supplier - Clinic/Group Practice 5395972996 Receives reassigned benefits from 31 practitioners
8 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Williamson, WV; Lavalette, WV; Matewan, WV; Delbarton, WV
O20250915000148 WV Part A Provider - Federally Qualified Health Center (FQHC) 5395972996 Practice locations: Matewan, WV

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1386360683. Details of each certification follow.

Federally qualified health center certification: CCN 581078

Legal name
WILLIAMSON HEALTH & WELLNESS CENTER INC
Doing business as
WILLIAMSON HEALTH & WELLNESS CENTER-MATEWAN PK-8
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Oct 28, 2025
Last certification
Oct 28, 2025
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Enrollment address
104 Chambers St.
Matewan, WV 25678

Other NPIs with the same Medicare PAC ID 14

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 14

Other NPIs on the same Medicare enrollment 8

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

National Provider Directory

National Provider Directory
Tax ID family
Williamson Health Wellness18 organizations share this tax ID, including this one
Part of
Williamson Health Wellness

Other organizations with this tax ID 17

Organizations that report the same tax identification number in the National Provider Directory.

View all 17

Member of 1

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

Locations

104 Chambers St
Matewan, WV 25678
Phone (304) 426-8569

Ownership & related parties

All disclosed owners & managing parties 11

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

NameRoleSinceShare
Sherry Hatfield Individual Corporate DirectorBoard Member May 18, 2025
Mabel Childress Individual Corporate DirectorBoard of Directors May 18, 2025
Chris Canterbury Individual Corporate DirectorChair/Board of Directors May 18, 2025
Christopher Donovan Beckett Individual Corporate OfficerCeo Mar 12, 2014 100%
Corporate DirectorCeo Mar 12, 2014 100%
W-2 Managing EmployeeCeo/Physician Mar 12, 2014 100%
Nicole McNamee Individual Corporate DirectorVice Chair-Board of Directors May 18, 2025
Sherri Brown Individual Corporate DirectorTreasurer May 18, 2025
Virginia Farley Individual Corporate DirectorBoard Member May 18, 2025
Dennis Wilson Individual Corporate DirectorMember/Boards of Directors May 18, 2025
Williamson Health & Wellness Center Inc Organization, Williamson, WV 5% Or Greater Direct Ownership Interest Oct 1, 2024 100%
Carole Steele Individual Corporate DirectorBoard of Directors May 18, 2025
Jacqueline Branch Individual Corporate DirectorSecretary May 18, 2025

Owners & managing parties with NPI records 15

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

View all 15

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Williamson Health & Wellness Center- Behavioral Medicine ClinicWilliamson, WV, CCN 510094 Hospital 5% Or Greater Direct Ownership Interest (100%) May 31, 2020
Williamson Health & Wellness Center IncWilliamson, WV, CCN 511032 Federally qualified health center Operational/Managerial Control Sep 3, 2013

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 2

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

NPI Registry JSON

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

{
    "created_epoch": "1666051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666051200000",
    "number": "1386360683",
    "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",
            "telephone_number": "304-236-5902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 CHAMBERS ST.",
            "city": "MATEWAN",
            "state": "WV",
            "postal_code": "25678",
            "telephone_number": "304-426-8569"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIAMSON HEALTH & WELLNESS CENTER INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WILLIAMSON HEALTH & WELLNESS CENTER INC",
        "enumeration_date": "2022-10-18",
        "last_updated": "2022-10-18",
        "certification_date": "2022-10-12",
        "status": "A",
        "authorized_official_last_name": "BECKETT",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "DONOVAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "304-236-5902",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Williamson Health & Wellness Center- Matewan PK-8",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Matewan, WV

Sources for this page

Verify at the official NPI Registry.