NPIMap

Organization Active NPI

Bon Secours Mercy Health Franklin LLC

Doing business as Bon Secours - Southampton Medical Center

  • Medicare Defined Swing Bed Hospital Unit
  • Franklin, VA
National Provider Identifier
1295370328
Registry record updated Nov 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
Legal business name
BON SECOURS MERCY HEALTH FRANKLIN LLC
Doing business as
Bon Secours - Southampton Medical Center
Practice address
100 Fairview Dr
Franklin, VA 23851-1238
Phone
(757) 569-6100
NPI assigned
Nov 13, 2019
Last updated
Nov 23, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2020

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

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X Primary

Addresses

Primary practice location

100 Fairview Dr
Franklin, VA 23851-1238

Mailing address

PO Box 639857
Cincinnati, OH 45263-9857

Other names 1

  • BON SECOURS - SOUTHAMPTON MEDICAL CENTER Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200110000550 VA Part A Provider - Hospital 9436583242 Practice locations: Franklin, VA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1295370328. Details of each certification follow.

Hospital certification: CCN 49U092

Legal name
BON SECOURS MERCY HEALTH FRANKLIN LLC
Doing business as
BON SECOURS SOUTHAMPTON MEMORIAL HOSPITAL
Organization structure
LLCNon-profit
Enrollment address
100 Fairview Dr
Franklin, VA 23851-1238
Hospital Swing-Bed Unit
Hospital subgroups
Swing-bed approved

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

Other NPIs with the same Medicare PAC ID 2

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

National Provider Directory

National Provider Directory
Tax ID family
Bon Secours Mercy Health Franklin LLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

210 Fairview Dr
#B
Franklin, VA 23851
Phone (757) 569-6175

Interoperability endpoints

  • FHIR API: https://carepath.health-partners.org/Proxy-FHIR/BBSHSI/api/FHIR/R4

Ownership & related parties

All disclosed owners & managing parties 18

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

NameRoleSinceShare
Ann M Kirk Individual Corporate DirectorBoard Member Jan 1, 2025
Kevin Clark Individual Corporate DirectorBoard Member Jan 1, 2026
Angela Reddix Individual Corporate DirectorBoard Member Jan 1, 2026
Patricia Davis-Hagens Individual Corporate DirectorBoard Member Oct 18, 2021
David a Cannady Individual Corporate DirectorBoard Member Jan 1, 2023
Brian Yanofchick Individual Corporate DirectorBoard 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 OtherCho Admin Jan 1, 2020
Dawn Glynn Individual Corporate DirectorBoard Member Jan 1, 2024
Bon Secours Hampton Roads Health System Inc Organization, Suffolk, VA Corporation, Non-profit, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Jan 1, 2020 100%
Corey McCray Individual Corporate DirectorBoard Member Jan 1, 2024
Raymond L McCue Individual Corporate DirectorBoard Member Jan 1, 2026
Teresa Beale Individual Corporate DirectorBoard Member Jan 1, 2022
Jonathan L Haynes Individual Corporate OfficerCfo Harmpton MKT Jan 1, 2022
Corporate DirectorBoard Member Jan 1, 2022
W-2 Managing EmployeeCfo Hampton MKT Jan 1, 2022
John E Snellings Individual Corporate DirectorBoard Member Jan 1, 2026
Cynthia C Romero Individual Corporate DirectorBoard Member Jan 1, 2020
Kimberly M Ralston Individual W-2 Managing EmployeeVP Reimbursement Jan 1, 2020
Joy L Jefferson Individual Corporate DirectorBoard Member Jan 1, 2025

Owners & managing parties with NPI records 2

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

Facilities with the same owner 97

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

View all 97

NPI Registry JSON

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

{
    "created_epoch": "1573603200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1606089600000",
    "number": "1295370328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 639857",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452639857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 FAIRVIEW DR",
            "city": "FRANKLIN",
            "state": "VA",
            "postal_code": "238511238",
            "telephone_number": "757-569-6100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BON SECOURS MERCY HEALTH FRANKLIN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-13",
        "last_updated": "2020-11-23",
        "certification_date": "2020-11-23",
        "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": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BON SECOURS - SOUTHAMPTON MEDICAL CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Franklin, VA

Sources for this page

Verify at the official NPI Registry.