Active NPI
Mount Carmel Rehabilitation & Nursing Center
- Skilled Nursing Facility
- Manchester, NH
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 00580
- Legal business name
- MOUNT CARMEL REHABILITATION & NURSING CENTER
- Practice address
- 235 Myrtle St
Manchester, NH 03104-4314 - Phone
- (603) 627-3811
- Fax
- (603) 626-4696
- NPI assigned
- Oct 5, 2005
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Joe Bohunicky
- Title
- Administrator
- Phone
- (603) 627-3811
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 00580 | NH | Primary |
Addresses
Primary practice location
235 Myrtle St
Manchester, NH 03104-4314
Mailing address
235 Myrtle St
Manchester, NH 03104-4314
Phone (603) 627-3811
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 30593558 | Medicaid | NH | |
| 99006643 | Medicaid | NH |
Other names 1
- Mount Carmel Rehab Center
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NH
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20030224000041 | NH | Part A Provider - Skilled Nursing Facility | 6901715440 | Practice locations: Manchester, NH |
Skilled nursing facility certification: CCN 305067
- Legal name
- MOUNT CARMEL REHABILITATION & NURSING CENTER
- Doing business as
- MOUNT CARMEL REHABILITATION & NURSING CENTER
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Apr 1, 1996
- Last certification
- May 22, 2024
- Beds
- 122
- Ownership / control type
- Church Related
- Multi-facility organization
- Catholic Charities of New Hampshire
- Organization structure
- Corporation
- Incorporated
- Mar 7, 1946 in NH
- Enrollment address
- 235 Myrtle St
Manchester, NH 03104-4314 - Nursing home name
- MOUNT CARMEL REHABILITATION AND NURSING CENTER
- Affiliated entity
- CATHOLIC CHARITIES NEW HAMPSHIRE
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Mount Carmel Rehabilitation and Nursing Center
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- Non profit - Church related
- Certified
- Apr 1, 1996
- Medicare certification status
- Active
- Certified beds
- 122
- Chain
- Catholic Charities New Hampshire
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 30D0085748 | Mt Carmel Rehabilitation & Nursing Center | Certificate of waiver | Dec 15, 2027 |
National Provider Directory
National Provider DirectoryMember of 1
Organizations this organization is a member of, according to the National Provider Directory.
Ownership & related parties
All disclosed owners & managing parties 23
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Sarah E Richardson | W-2 Managing Employee | Oct 18, 2018 | |
| Anu Mullikin | Corporate Director | Sep 1, 2016 | |
| Jeffrey McLean | Corporate Director | Sep 1, 2021 | |
| Thomas Blonski | Corporate Officer | Jul 1, 2006 | |
| W-2 Managing Employee | Jul 1, 2006 | ||
| Peter a Libasci | Corporate Director | Sep 1, 2011 | |
| Russ Ouellette | Corporate Director | Sep 1, 2017 | |
| Karen a Zirkle | W-2 Managing Employee | Oct 18, 2018 | |
| Tina Legere | Corporate Director | Sep 1, 2018 | |
| John Patenaude | Corporate Director | Sep 1, 2018 | |
| Catherine Mirable | Corporate Director | Sep 1, 2019 | |
| Susan D Huard | Corporate Director | Sep 1, 2020 | |
| Joseph Bohunicky | W-2 Managing Employee | Jan 1, 2016 | |
| Kevin Barrett | Corporate Director | Sep 1, 2016 | |
| NH Catholic Charities Inc | 5% Or Greater Direct Ownership Interest | Jan 1, 1969 | 100% |
| Operational/Managerial Control | Jan 1, 1969 | ||
| David Z Hildenbrand | Corporate Officer | Apr 12, 2017 | |
| Kevin Paul Desrosiers | Corporate Director | Sep 1, 2020 | |
| Patrick H Ford | Corporate Director | Sep 1, 2019 | |
| Richard Hilton | Corporate Director | Sep 1, 2017 | |
| Edward James Powers | Corporate Director | Sep 1, 2018 | |
| Adam Coughlin | Corporate Director | Sep 1, 2020 | |
| Alain J Bernard | W-2 Managing Employee | Oct 1, 2018 | |
| Jason Jalbert | Corporate Director | Sep 1, 2017 | |
| Kate Baker Demers | Corporate Director | Sep 1, 2020 |
Owners & managing parties with NPI records 2
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Critical Care Medicine (Internal Medicine) Physician
- Manchester, NH
- NPI 1306062054
Corporate Director
-
- Clinical Social Worker
- Manchester, NH
- NPI 1255417408
5% Or Greater Direct Ownership Interest, Operational/Managerial Control
Facilities with the same owner 6
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
- Skilled Nursing Facility
- Manchester, NH
- NPI 1396724795
NH Catholic Charities Inc
-
- Skilled Nursing Facility
- Dover, NH
- NPI 1104805613
NH Catholic Charities Inc
-
- Skilled Nursing Facility
- Laconia, NH
- NPI 1386631265
NH Catholic Charities Inc
-
- Skilled Nursing Facility
- Manchester, NH
- NPI 1447247325
NH Catholic Charities Inc
-
- Skilled Nursing Facility
- Berlin, NH
- NPI 1326027830
NH Catholic Charities Inc
-
- Skilled Nursing Facility
- Windham, NH
- NPI 1417340613
NH Catholic Charities Inc
Practitioners & affiliated clinicians
Practitioners 3
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Geriatric Medicine (Internal Medicine) Physician
- Manchester, NH
- NPI 1578537254
-
- Internal Medicine Physician
- Pelham, NH
- NPI 1275700825
-
- Internal Medicine Physician
- Florence, SC
- NPI 1003913526
Affiliated clinicians 1
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": "1128470400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1570147200000",
"number": "1376530246",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "235 MYRTLE ST",
"city": "MANCHESTER",
"state": "NH",
"postal_code": "031044314",
"telephone_number": "603-627-3811",
"fax_number": "603-626-4696"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "235 MYRTLE ST",
"city": "MANCHESTER",
"state": "NH",
"postal_code": "031044314",
"telephone_number": "603-627-3811",
"fax_number": "603-626-4696"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MOUNT CARMEL REHABILITATION & NURSING CENTER",
"organizational_subpart": "NO",
"enumeration_date": "2005-10-05",
"last_updated": "2019-10-04",
"status": "A",
"authorized_official_last_name": "BOHUNICKY",
"authorized_official_first_name": "JOE",
"authorized_official_title_or_position": "ADMINISTRATOR",
"authorized_official_telephone_number": "603-627-3811",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "NH",
"license": "00580",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "30593558",
"state": "NH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "99006643",
"state": "NH"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Mount Carmel Rehab Center",
"code": "4",
"type": "Former Legal Business Name"
},
{
"organization_name": "Mount Carmel Rehab Center",
"code": "4",
"type": "Former Legal Business Name"
}
]
}
Other providers in Manchester, NH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.