NPIMap

Organization Active NPI

Community Health Systems Inc.

Doing business as WoodrowWilson/Act Wellness Center

  • Family Medicine Physician
  • Beckley, WV
National Provider Identifier
1730489865
Registry record updated Nov 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
COMMUNITY HEALTH SYSTEMS INC.
Doing business as
WoodrowWilson/Act Wellness Center
Practice address
390 Stanaford Rd
Beckley, WV 25801-3142
Phone
(304) 461-3320
NPI assigned
Oct 22, 2010
Last updated
Nov 15, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2010

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

Authorized official

Name
Mr. Charles Hunt
Title
Ceo
Phone
(304) 252-8324

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

390 Stanaford Rd
Beckley, WV 25801-3142

Mailing address

252 Rural Acres Dr
Beckley, WV 25801-3503
Phone (304) 252-1790

Other names 1

  • WoodrowWilson/Act Wellness Center Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040311000504 WV Part B Supplier - Public Health/Welfare Agency 6608785795 Receives reassigned benefits from 106 practitioners
10 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Beckley, WV
O20101108001002 WV Part A Provider - Federally Qualified Health Center (FQHC) 6608785795 Practice locations: Beckley, WV

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1730489865. Details of each certification follow.

Federally qualified health center certification: CCN 511958

Legal name
COMMUNITY HEALTH SYSTEMS INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Dec 27, 2010
Last certification
Dec 27, 2010
Ownership / control type
For profit – corporation
Organization structure
CorporationProprietary
Incorporated
Jun 20, 1967 in WV
Enrollment address
390 Stanaford Rd
Beckley, WV 25801-3142

Other NPIs on the same Medicare enrollment 10

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

National Provider Directory

National Provider Directory
Tax ID family
Community Health System45 organizations share this tax ID, including this one

Other organizations with this tax ID 44

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

View all 44

Locations

390 Stanaford Rd
Beckley, WV 25801
Phone (304) 461-3320

Ownership & related parties

All disclosed owners & managing parties 8

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

NameRoleSinceShare
Carl Bowman Individual Corporate Director Oct 10, 2010
W-2 Managing Employee Oct 10, 2010
Clyde Meador Individual Corporate Director Oct 10, 2010
W-2 Managing Employee Oct 10, 2010
Chris Davis Individual Corporate Director Oct 10, 2010
W-2 Managing Employee Oct 10, 2010
Susan England Individual Corporate Director Dec 15, 2010
Carolyn Dilorenzo Individual Corporate Director Oct 10, 2010
W-2 Managing Employee Oct 10, 2010
Jane Flanagan Individual Corporate Director Oct 10, 2010
W-2 Managing Employee Oct 10, 2010
Gregory Hazuka Individual Corporate Director Oct 10, 2010
W-2 Managing Employee Oct 10, 2010
Charles Hunt Individual Corporate Director Oct 10, 2010
W-2 Managing Employee Oct 10, 2010

All facility ownership & control disclosures 6

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

FacilityTypeRoleSince
Access HealthWelch, WV, CCN 511151 Federally qualified health center Operational/Managerial Control Aug 25, 2017
Community Health Systems IncBeckley, WV, CCN 511159 Federally qualified health center Operational/Managerial Control Oct 1, 2018
AccesshealthBeckley, WV, CCN 511175 Federally qualified health center Operational/Managerial Control Aug 1, 2019
Accesshealth Daniels Elementary SchoolDaniels, WV, CCN 511180 Federally qualified health center Operational/Managerial Control Apr 17, 2000
Community Health Systems IncBeckley, WV, CCN 581840 Federally qualified health center Operational/Managerial Control Apr 17, 2000
Accesshealth Stratton ElementaryBeckley, WV, CCN 581072 Federally qualified health center Operational/Managerial Control Oct 31, 2023

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1287705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1289779200000",
    "number": "1730489865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "252 RURAL ACRES DR",
            "city": "BECKLEY",
            "state": "WV",
            "postal_code": "258013503",
            "telephone_number": "304-252-1790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "390 STANAFORD RD",
            "city": "BECKLEY",
            "state": "WV",
            "postal_code": "258013142",
            "telephone_number": "304-461-3320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY HEALTH SYSTEMS INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-22",
        "last_updated": "2010-11-15",
        "status": "A",
        "authorized_official_last_name": "HUNT",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "304-252-8324",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WoodrowWilson/Act Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Beckley, WV

Sources for this page

Verify at the official NPI Registry.