NPIMap

Organization Active NPI

Community Mercy Health Partners

Doing business as Mercy Health - Urbana Hospital

  • Critical Access Hospital
  • Urbana, OH
National Provider Identifier
1144286352
Registry record updated Mar 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
Legal business name
COMMUNITY MERCY HEALTH PARTNERS
Doing business as
Mercy Health - Urbana Hospital
Practice address
904 Scioto St
Urbana, OH 43078
Phone
(937) 653-5231
NPI assigned
Apr 25, 2006
Last updated
Mar 2, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2021

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

Authorized official

Name
Kimberly M Ralston
Title
System Director
Phone
(419) 996-5119

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X Primary

Addresses

Primary practice location

904 Scioto St
Urbana, OH 43078

Mailing address

PO Box 636374
Cincinnati, OH 45263-6374
Phone (513) 952-5002

Other identifiers 1

IdentifierTypeStateIssuer
5887901MedicaidOH

Other names 1

  • MERCY HEALTH - URBANA HOSPITAL Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://172.254.9.13:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other BLUEMARK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20070524000003 OH Part A Provider - Critical Access Hospital 6002884582 Practice locations: Urbana, OH; Springfield, OH
O20200930002500 OH Part B Supplier - Intensive Cardiac Rehabilitation 6002884582 Receives reassigned benefits from 1 practitioner
Practice locations: Urbana, OH

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1144286352. Details of each certification follow.

Hospital certification: CCN 361312

Legal name
COMMUNITY MERCY HEALTH PARTNERS
Doing business as
MERCY HEALTH - URBANA HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
May 9, 2002
Last certification
Jul 28, 2011
Beds
25
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Aug 14, 1969 in OH
Enrollment address
904 Scioto St
Urbana, OH 43078-2226
Main/Primary Hospital Location

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

Other NPIs with the same Medicare PAC ID 5

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Mercy Health - Urbana HospitalCCN 361312 · All quality measures
Overall star rating
4 of 5
Type
Critical Access Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
Mercy ER Physicians23 organizations share this tax ID, including this one

Other organizations with this tax ID 22

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

View all 22

Ownership & related parties

All disclosed owners & managing parties 22

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

NameRoleSinceShare
Jayna Nicole Brown Individual Corporate DirectorBoard Member Jan 1, 2021
Denise Rodney Individual Corporate DirectorBoard Member Jan 1, 2024
Maria Goeser Individual Corporate DirectorBoard Member Jan 1, 2021
Michael Greitzer Individual Corporate DirectorBoard Member Jan 1, 2018
Marvin Millan Narcelles Individual Corporate DirectorBoard Member Jan 1, 2019
Adam Groshans Individual Corporate DirectorBoard Member Jun 1, 2019
Truman Johnson Individual Corporate DirectorBoard Member Jan 1, 2018
Jenelle Zelinski Individual Corporate OfficerCfo May 20, 2019
Corporate DirectorBoard Member May 20, 2019
W-2 Managing EmployeeCfo May 20, 2019
James McGregor Individual Corporate DirectorBoard Member Jan 1, 2022
Lisa Cole Individual Corporate DirectorBoard Member Jan 1, 2020
Bon Secours Mercy Health Inc Organization, Cincinnati, OH Corporation, Non-profit, Chain home office 5% Or Greater Indirect Ownership Interest Sep 1, 2018 50%
Ryan Gilliam Individual Corporate DirectorBoard Member Jan 1, 2025
Nina Wiley Individual Corporate DirectorBoard Member Jan 1, 2020
Alexander Garvey Individual Corporate DirectorBoard Member Jan 1, 2023
John Starcher Individual Operational/Managerial ControlCho Admin Feb 1, 2016
Maryann Potina Individual Corporate DirectorBoard Member Jan 1, 2022
Adeleye a Edon Individual Corporate DirectorBoard Member Jan 1, 2022
The Community Hospital Health Services Foundation Organization, Springfield, OH Non-profit 5% Or Greater Indirect Ownership Interest Jul 1, 2004 50%
Community Mercy Health System Organization, Springfield, OH Non-profit 5% Or Greater Direct Ownership Interest Jul 1, 2004 100%
William Ray Individual Corporate DirectorBoard Member Feb 1, 2015
Kimberly M Ralston Individual W-2 Managing EmployeeVP Reimbursement Oct 7, 2017
Joseph Gage Individual Corporate DirectorBoard Member Jan 1, 2023

Owners & managing parties with NPI records 3

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

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
Community Mercy Home CareSpringfield, OH, CCN 367447 Home health agency 5% Or Greater Direct Ownership Interest (50%) Oct 11, 2005

Owned or controlled facilities with NPI records 1

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

Facilities with the same owner 97

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

View all 97

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 108

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

View all 108

NPI Registry JSON

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

{
    "created_epoch": "1145923200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614643200000",
    "number": "1144286352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 636374",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452636374",
            "telephone_number": "513-952-5002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "904 SCIOTO ST",
            "city": "URBANA",
            "state": "OH",
            "postal_code": "43078",
            "telephone_number": "937-653-5231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY MERCY HEALTH PARTNERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-25",
        "last_updated": "2021-03-02",
        "certification_date": "2021-03-02",
        "status": "A",
        "authorized_official_last_name": "RALSTON",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "SYSTEM DIRECTOR",
        "authorized_official_telephone_number": "419-996-5119"
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5887901",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://172.254.9.13:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.2019.1",
            "affiliationName": "BLUEMARK",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "40 Sunset Ridge Rd Ste 120",
            "city": "New Paltz",
            "state": "NY",
            "country_code": "US",
            "postal_code": "125611039",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "MERCY HEALTH - URBANA HOSPITAL",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Urbana, OH

Sources for this page

Verify at the official NPI Registry.