Individual provider Active NPI

Christy Lynn Williams, AGNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Scott Depot, WV
National Provider Identifier
1730624198
Registry record updated Jun 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
84954 Issued in WV
Practice address
97 Great Teays Blvd Ste 6
Scott Depot, WV 25560-9816
Phone
(304) 757-6999
Fax
(304) 760-6318
NPI assigned
Dec 21, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X APRN84954-AGPCNP-BC WV
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 84954 WV Primary

Addresses

Primary practice location

97 Great Teays Blvd Ste 6
Scott Depot, WV 25560-9816

Mailing address

97 Great Teays Blvd Ste 6
Scott Depot, WV 25560-9816
Phone (304) 757-6999

Other identifiers 1

IdentifierTypeStateIssuer
1730624198MedicaidWV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170802000063 WV Practitioner - Nurse Practitioner 2264703768 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Westbrook Health Services IncGroup PAC ID 3375443054, 31 clinicians

Practice addresses (Care Compare)

2121 7TH St
Parkersburg, WV 26101-3803
Phone (304) 485-1721

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APRN84954-AGPCNP-BCWVMDAdult Health Nurse Practitioner
84954WVMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Womencare Inc Current Accepting new patients
Womencare, Inc CurrentSince Jun 8, 2020 Accepting new patients
Womencare Inc Current Accepting new patients
Womencare Inc Current Accepting new patients
Womencare Inc Current Accepting new patients
Womencare, Inc Current Accepting new patients
Womencare, Inc Current Accepting new patients
Womencare Inc Current Accepting new patients
Women Care Inc CurrentSince Jun 8, 2020 Accepting new patients
Westbrook Health Services, Inc. Current Accepting new patients
Womencare Inc Current Accepting new patients
Womencare Inc Current Accepting new patients
Womencare Inc Current Accepting new patients
Womencare Inc Current Accepting new patients
Womencare Inc Current Accepting new patients

Locations

501 Stockton St
Charleston, WV 25387
Phone (304) 720-4466

116 Hills Plz
Charleston, WV 25387
Phone (304) 720-4446

503 Roosevelt Blvd
Eleanor, WV 25070
Phone (304) 586-0001

515 Main St
Madison, WV 25130
Phone (304) 369-0393

2121 7th St
Parkersburg, WV 26101
Phone (304) 485-1721

12 Kanawha Ter
Saint Albans, WV 25177
Phone (304) 201-1130

97 Great Teays Blvd
Ste 6
Scott Depot, WV 25560

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/7363/brand/1/csg/1/fhir/r4

Organizations & group practices 15

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1482278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592524800000",
    "number": "1730624198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "97 GREAT TEAYS BLVD STE 6",
            "city": "SCOTT DEPOT",
            "state": "WV",
            "postal_code": "255609816",
            "telephone_number": "304-757-6999",
            "fax_number": "304-201-5019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "97 GREAT TEAYS BLVD STE 6",
            "city": "SCOTT DEPOT",
            "state": "WV",
            "postal_code": "255609816",
            "telephone_number": "304-757-6999",
            "fax_number": "304-760-6318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "CHRISTY",
        "middle_name": "LYNN",
        "credential": "AGNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-21",
        "last_updated": "2020-06-19",
        "certification_date": "2020-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "WV",
            "license": "APRN84954-AGPCNP-BC",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WV",
            "license": "84954",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1730624198",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Scott Depot, WV

Sources for this page

Verify at the official NPI Registry.