NPIMap

Organization Active NPI

St Mary Rehabilitation Hospital LLP

Doing business as St Mary Rehabilitation Hospital

  • Rehabilitation Hospital
  • Langhorne, PA
National Provider Identifier
1083041776
Registry record updated Aug 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation HospitalTaxonomy code 283X00000X
Legal business name
ST MARY REHABILITATION HOSPITAL LLP
Doing business as
St Mary Rehabilitation Hospital
Practice address
1208 Newton-Langhorne Road
Langhorne, PA 19047
Phone
(314) 881-4275
NPI assigned
Sep 26, 2013
Last updated
Aug 28, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2019

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

Authorized official

Name
Lisa Haney
Title
Ceo
Phone
(267) 688-0711

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Hospital 283X00000X NU Primary

Addresses

Primary practice location

1208 Newton-Langhorne Road
Langhorne, PA 19047

Mailing address

1208 Newton-Langhorne Road
Langhorne, PA 19047

Other names 1

  • St Mary Rehabilitation Hospital Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140310000111 PA Part A Provider - Hospital 1658501820 Practice locations: Langhorne, PA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1083041776. Details of each certification follow.

Hospital certification: CCN 393055

Legal name
ST MARY REHABILITATION HOSPITAL LLP
Doing business as
ST MARYS REHABILITATION HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Rehabilitation
Participating since
Jul 11, 2014
Last certification
Oct 24, 2023
Beds
50
Ownership / control type
Private (for profit)
Organization structure
PartnershipProprietary
Incorporated
Nov 4, 2010 in DE
Enrollment address
1208 Langhorne Newtown Rd
Langhorne, PA 19047-1234
Other Hospital Practice Location
Hospital subgroups
Rehabilitation

Care Compare: Inpatient rehabilitation facility

Medicare Care Compare
Listed as
St Mary Rehabilitation HospitalCCN 393055 · All quality measures
Ownership
For profit
Certified
Jul 11, 2014
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
39D2077348St Mary Rehabilitation Hospital Lab1208 Langhorne-Newtown Road, Langhorne, PA 19047Certificate of waiverMay 5, 2028

National Provider Directory

National Provider Directory

Member of 1

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

Locations

1200 Langhorne Newtown Rd
Langhorne, PA 19047
Phone (267) 688-0711

Ownership & related parties

All disclosed owners & managing parties 17

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

NameRoleSinceShare
Donna Flannery Individual Corporate DirectorBoard Member Jan 31, 2019
Lifepoint Rehab Blocker LLC Organization, Brentwoo, TN LLC Other Dec 31, 2022 41%
Thomas Bobroski Individual Corporate DirectorBoard Member May 9, 2024
Nicole Yerger Individual Corporate DirectorBoard Member Feb 8, 2024
CHC Management Services LLC Organization, Brentwoo, TN LLC, For-profit Operational/Managerial Control Nov 4, 2010 100%
Lifepoint Rehab LLC Organization, Brentwood, TN LLC 5% Or Greater Indirect Ownership Interest Dec 23, 2021 41%
DSB Acquisition LLC Organization, New York, NY LLC 5% Or Greater Indirect Ownership Interest Dec 23, 2021 41%
St Mary Medical Center Organization, Langhorne, PA Non-profit 5% Or Greater Direct Ownership Interest Nov 4, 2010 59%
CRH of Langhorne LLC Organization, Brentwoo, TN For-profit 5% Or Greater Direct Ownership Interest Jan 1, 2015 41%
David a Wajda Individual Corporate DirectorBoard Member Aug 12, 2022
Lifepoint Health Inc Organization, Brentwood, TN Corporation 5% Or Greater Indirect Ownership Interest Dec 23, 2021 41%
Lisa a Staback Individual Corporate OfficerHospital Ceo Jul 18, 2011 100%
Operational/Managerial ControlHospital Ceo Jul 18, 2011 100%
Marcus B Poppell Individual OtherVice President Dec 23, 2021
David I Stark Individual Corporate DirectorBoard Member Apr 18, 2019
Michael a Magro Individual Corporate Director Jul 1, 2022
Centerre Healthcare LLC Organization, Brentwoo, TN LLC, For-profit 5% Or Greater Indirect Ownership Interest Mar 28, 2019 41%
Lifepoint Rehab Blocker Parent LLC Organization, Brentwood, TN LLC 5% Or Greater Indirect Ownership Interest Dec 23, 2021 41%

Owners & managing parties with NPI records 3

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

Facilities with the same owner 70

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

View all 70

Practitioners & affiliated clinicians

Practitioners 5

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.

Affiliated clinicians 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1380153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1566950400000",
    "number": "1083041776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1208 NEWTON-LANGHORNE ROAD",
            "city": "LANGHORNE",
            "state": "PA",
            "postal_code": "19047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1208 NEWTON-LANGHORNE ROAD",
            "city": "LANGHORNE",
            "state": "PA",
            "postal_code": "19047",
            "telephone_number": "314-881-4275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST MARY REHABILITATION HOSPITAL LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-26",
        "last_updated": "2019-08-28",
        "status": "A",
        "authorized_official_last_name": "HANEY",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "267-688-0711"
    },
    "taxonomies": [
        {
            "code": "283X00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Hospital",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St Mary Rehabilitation Hospital",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "St Mary Rehabilitation Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Langhorne, PA

Sources for this page

Verify at the official NPI Registry.