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Organization Active NPI

Bon Secours Mercy Health Emporia LLC

  • General Acute Care Hospital
  • Emporia, VA
National Provider Identifier
1104461276
Registry record updated Nov 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
Legal business name
BON SECOURS MERCY HEALTH EMPORIA LLC
Practice address
727 N Main St
Emporia, VA 23847-1274
Phone
(434) 348-4400
NPI assigned
Nov 13, 2019
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Kimberly Ralston
Title
System Director
Phone
(419) 996-5119

Owners & managing parties with NPI records 1

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

Other NPIs with the same Medicare PAC ID 2

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

Corporate family (same tax ID) 2

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

Facilities connected through Provider of Services related, parent or unit certification numbers.

Facilities with the same owner 97

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

View all 97

Affiliated clinicians 118

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

View all 118

Medicare Care Compare: Hospital

Listed as
Bon Secours Southern Virginia Medical Center CCN 490097
Overall star rating
★★★★☆ 4 of 5
Type
Acute Care Hospitals
Ownership
Proprietary
Medicare certification status
Active (Provider of Services file)
Emergency services
Yes

Source: Medicare Care Compare.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in VA

Hospital certification: CCN 490097

Legal name
BON SECOURS MERCY HEALTH EMPORIA LLC
Doing business as
BON SECOURS SOUTHERN VIRGINIA MEDICAL CENTER
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Sep 29, 1966
Last certification
Oct 10, 2012
Beds
80
Ownership / control type
Private (for profit)
Most recent change of ownership
Jan 1, 2020 (2 total)
Organization structure
LLC · Non-profit
Enrollment address
727 N Main St
Emporia, VA 23847-1274
Main/Primary Hospital Location
Hospital subgroups
Acute care

All disclosed owners & managing parties 19

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

NameRoleSinceShare
Jeffrey Szyperski
Individual 		Corporate Director
Board Member		 Jan 1, 2024
Rebecca W McDonough
Individual 		Corporate Director
Board Member		 Jan 1, 2025
Paula P Pando
Individual 		Corporate Director
Board Member		 Jan 1, 2025
Robert Ukrop
Individual 		Corporate Director
Board Member		 Jan 1, 2025
Wael N Haidar
Individual 		Corporate Director
Board Member		 Jan 1, 2023
Osman Parvaiz
Individual 		Corporate Director
Board Member		 Jan 1, 2025
Lang R Liebman
Individual 		Corporate Director
Board Member		 Jan 1, 2022
James Carter
Individual 		Corporate Director
Board Member		 Jan 1, 2025
Brian Yanofchick
Individual 		Corporate Director
Board Member		 Jan 1, 2020
Bon Secours Mercy Health Inc
Organization · Blue Ash, OH
Corporation, Non-profit, Chain home office 		5% Or Greater Indirect Ownership Interest Jan 1, 2020 100%
John Starcher
Individual 		Operational/Managerial Control
Cho Admin		 Jan 1, 2020
Regina J Elbert
Individual 		Corporate Director
Board Member		 Jan 1, 2022
Michael Quinones
Individual 		Corporate Director
Board Member		 Jan 1, 2023
William Kusnierz
Individual 		Corporate Officer
Cfo Richmond MKT		 Sep 8, 2020
Corporate Director
Cfo Richmond MKT		 Sep 8, 2020
Mary Shimo
Individual 		Corporate Director
Board Member		 Apr 22, 2022
Bon Secours Richmond LLC
Organization · Marriottsville, MD
LLC, Non-profit 		5% Or Greater Direct Ownership Interest Jan 1, 2020 100%
Michael John Lutes
Individual 		Corporate Director
Board Member		 Oct 1, 2022
Devon Henry
Individual 		Corporate Director
Board Member		 Jan 1, 2024
Kimberly M Ralston
Individual 		W-2 Managing Employee
VP Reimbursement		 Jan 1, 2020

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20200106000278 VA Part a Provider - Hospital 9537593256 Practice locations: Emporia, VA

National Provider Directory

Tax ID family
Bon Secours Mercy Health Emporia LLC (3 organizations share this tax ID)

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X Primary

Addresses

NPPES NPI Registry

Primary practice location

727 N Main St
Emporia, VA 23847-1274

Mailing address

PO Box 639858
Cincinnati, OH 45263-9858

Other names 1

NPPES NPI Registry
  • BON SECOURS SOUTHERN VIRGINIA MEDICAL CENTER Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Nov 11, 2021.

{
    "created_epoch": "1573603200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1636588800000",
    "number": "1104461276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 639858",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452639858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "727 N MAIN ST",
            "city": "EMPORIA",
            "state": "VA",
            "postal_code": "238471274",
            "telephone_number": "434-348-4400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BON SECOURS MERCY HEALTH EMPORIA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-13",
        "last_updated": "2021-11-11",
        "certification_date": "2021-11-11",
        "status": "A",
        "authorized_official_last_name": "RALSTON",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "SYSTEM DIRECTOR",
        "authorized_official_telephone_number": "419-996-5119"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BON SECOURS SOUTHERN VIRGINIA MEDICAL CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Emporia, VA

Sources for this page

Verify at the official NPI Registry.