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Organization Active NPI

Mercy Health-Regional Medical Center LLC

  • Rehabilitation Hospital Unit
  • Lorain, OH
National Provider Identifier
1295808152
Registry record updated May 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Hospital UnitTaxonomy code 273Y00000X
Legal business name
MERCY HEALTH-REGIONAL MEDICAL CENTER LLC
Practice address
3700 Kolbe Rd
Lorain, OH 44053-1611
Phone
(440) 960-4000
Fax
(440) 960-3359
NPI assigned
Nov 16, 2006
Organization subpart
Yes
Parent organization
MERCY HEALTH LORAIN LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 20, 2022

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

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Hospital Unit 273Y00000X Primary

Addresses

Primary practice location

3700 Kolbe Rd
Lorain, OH 44053-1611

Mailing address

PO Box 636409
Cincinnati, OH 45263-6409
Phone (440) 960-4000

Other identifiers 1

IdentifierTypeStateIssuer
5281350MedicaidOH

Other names 1

  • Mercy Health-Lorain Hospital Rehabilitation Center 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 OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080116000646 OH Part A Provider - Hospital 3577471101 Practice locations: Lorain, OH

Hospital certification: CCN 36T172

Legal name
MERCY HEALTH-REGIONAL MEDICAL CENTER LLC
Doing business as
MERCY HEALTH-LORAIN HOSPITAL REHABILITATION CENTER
Organization structure
LLCNon-profit
Incorporated
Sep 22, 1927 in OH
Enrollment address
3700 Kolbe Rd
Lorain, OH 44053-1611
Hospital Rehabilitation Unit
Hospital subgroups
Rehabilitation unit

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

Other NPIs with the same Medicare PAC ID 4

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

Care Compare: Inpatient rehabilitation facility

Medicare Care Compare
Listed as
Mercy Regional Medical CenterCCN 36T172
Ownership
Non-profit
Certified
Jan 1, 1984

National Provider Directory

National Provider Directory
Tax ID family
Mercy Health Regional Med7 organizations share this tax ID, including this one
Part of
Community Health Partners Regional Health System

Other organizations with this tax ID 6

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

Locations

1800 Medical Center Dr
Ste 100
Sn Bernrdno, CA 92411
Phone (909) 255-0707

3700 Kolbe Rd
Ste 104
Lorain, OH 44053
Phone (440) 960-4000

Ownership & related parties

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
Parris Smith Individual Corporate DirectorBoard Member Jan 1, 2022
Robert L Thomas Individual Corporate DirectorBoard Member Jan 1, 2022
Michelle Crawford Individual Corporate DirectorBoard Member Jan 3, 2022
Barbara Thomas Individual Corporate DirectorBoard Member Feb 22, 2018
Kathleen Kern Individual Corporate DirectorBoard Member Jan 1, 2025
Darin Wiswell Individual Corporate DirectorBoard Member Jan 1, 2025
Bon Secours Mercy Health Inc Organization, Cincinnati, OH Corporation, Non-profit, Chain home office 5% Or Greater Indirect Ownership Interest Sep 1, 2018 100%
Alexander Garvey Individual Corporate DirectorBoard Member Jan 1, 2025
John Starcher Individual Operational/Managerial ControlCho Admin Feb 1, 2016
Darryl Tucker Individual Corporate DirectorBoard Member Feb 22, 2018
John Luellen Individual Corporate DirectorBoard Member Jan 1, 2022
Cindy Andrews Individual Corporate DirectorBoard Member Feb 1, 2017
Victor Leandry Individual Corporate DirectorBoard Member Feb 1, 2017
Tracy Green Individual Corporate DirectorBoard Member Feb 1, 2017
Cynthia L Dennison Individual Corporate OfficerCfo May 24, 2019
Corporate DirectorCfo May 24, 2019
W-2 Managing EmployeeCfo May 24, 2019
Randall Fortin Individual Corporate DirectorBoard Member Aug 5, 2010
Richard B White Individual Corporate DirectorBoard Member Jan 1, 2022
Kimberly M Ralston Individual W-2 Managing EmployeeVP Reimbursment Oct 7, 2017
Mercy Health Lorain LLC Organization, Lorain, OH Non-profit 5% Or Greater Direct Ownership Interest Nov 5, 2003 100%
Operational/Managerial Control Nov 5, 2003

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

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Affiliated clinicians 3

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

NPI Registry JSON

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

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1653004800000",
    "number": "1295808152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 636409",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452636409",
            "telephone_number": "440-960-4000",
            "fax_number": "440-960-3359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 KOLBE RD",
            "city": "LORAIN",
            "state": "OH",
            "postal_code": "440531611",
            "telephone_number": "440-960-4000",
            "fax_number": "440-960-3359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCY HEALTH-REGIONAL MEDICAL CENTER LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MERCY HEALTH LORAIN LLC",
        "enumeration_date": "2006-11-16",
        "last_updated": "2022-05-20",
        "certification_date": "2022-05-20",
        "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",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "273Y00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Unit",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5281350",
            "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-Lorain Hospital Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lorain, OH

Sources for this page

Verify at the official NPI Registry.