Mercy Health - St Vincent Medical Center LLC
Organization Active NPI Psychiatric Hospital Unit · Oregon, OH
NPI 1437812948 · NPPES record last updated Sep 25, 2024
Key facts
- NPI
- 1437812948
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Psychiatric Hospital Unit 273R00000X
- Legal business name
- MERCY HEALTH - ST VINCENT MEDICAL CENTER LLC
- Practice address
- 2600 Navarre Ave
Oregon, OH 43616-3207 - Phone
- (419) 696-7200
- NPI assigned
- Oct 21, 2021
- Organization subpart
- No
Authorized official
- Name
- Kimberly M Ralston
- Title
- System Director
- Phone
- (419) 996-5119
Owners & managing parties with NPI records 1
-
Randall W King, MD
Other NPIs with the same Medicare PAC ID 3
Corporate family (same tax ID) 11
Related certifications (CCN) 1
Facilities with the same owner 97
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
Hospital certification: CCN 36S112
- Legal name
- MERCY HEALTH - ST VINCENT MEDICAL CENTER LLC
- Doing business as
- MERCY HEALTH - ST VINCENT MEDICAL CENTER LLC
- Organization structure
- LLC · Non-profit
- Incorporated
- Jul 15, 1875 in OH
- Enrollment address
- 2600 Navarre Ave
Oregon, OH 43616-3207 - Hospital subgroups
- Psychiatric unit
All disclosed owners & managing parties 21
| Name | Role | Since | Share |
|---|---|---|---|
| Dale Thornton |
Corporate Director |
Jan 1, 2022 | |
| Gina Skolmowski |
Corporate Director |
Jan 1, 2019 | |
| Wendy Huntley |
Corporate Director |
Jan 1, 2020 | |
| Mercy Health North LLC |
5% Or Greater Direct Ownership Interest | Jul 1, 1966 | 100% |
| Timothy Goligoski |
Corporate Director |
Feb 22, 2024 | |
| Mark Ridenour |
Corporate Director |
Apr 1, 2012 | |
| Wael N Haidar |
Corporate Director |
Jan 1, 2023 | |
| Jason Kucsma |
Corporate Director |
Jan 1, 2021 | |
| Robert Baxter |
Corporate Director |
Jun 12, 2017 | |
| David Zenk |
Corporate Director |
Jan 1, 2021 | |
| Bon Secours Mercy Health Inc |
5% Or Greater Indirect Ownership Interest | Sep 1, 2018 | 100% |
| Alexander Garvey |
Corporate Director |
Jan 1, 2025 | |
| John Starcher |
Operational/Managerial Control |
Feb 1, 2016 | |
| Jeffrey Dempsey |
Corporate Officer |
Jul 20, 2017 | |
| Corporate Director |
Jul 20, 2017 | ||
| W-2 Managing Employee |
Jul 20, 2017 | ||
| Marvin L Whitfield |
Corporate Director |
Jan 1, 2025 | |
| Randall William King |
Corporate Director |
Jan 1, 2022 | |
| James Brazeau |
Corporate Director |
Jan 1, 2026 | |
| Bridget Deegan-Krause |
Corporate Director |
Jan 1, 2019 | |
| Kimberly M Ralston |
W-2 Managing Employee |
Oct 7, 2017 | |
| Thomas E Bush |
Corporate Director |
Jan 1, 2026 | |
| Luis Santiago |
Corporate Director |
Jan 1, 2023 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20220812002032 | OH | Part a Provider - Hospital | 2466444906 | Practice locations: Oregon, OH |
National Provider Directory
- Tax ID family
- Saint Vincents Medical
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric Hospital Unit | 273R00000X | Yes |
Addresses
Primary practice location
2600 Navarre Ave
Oregon, OH 43616-3207
Mailing address
PO Box 636447
Cincinnati, OH 45263-6447
Phone (419) 696-7200
Other names
- MERCY HEALTH - BEHAVIORAL HEALTH CENTER, ST. CHARLES
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://172.254.9.13:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service | Other | Bluemark Rehab LLC |
Other providers in Oregon, OH
- Medx Pharmacy LLC
- Meijer Stores Limited Partnership
- Valerie Kay Meinke
- Mercy Eye Institute, LLC
- Mercy Health - St Vincent Medical Center LLC
- Mercy Health - St Vincent Medical Center LLC
- Mercy Health - St Vincent Medical Center LLC
- Mercy Health Physicians North Specialty Care LLC
- Mercy Health Physicians-North LLC
- Mercy Health-St Charles Hospital LLC
All providers in Oregon, OH · Psychiatric Hospital Unit in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 25, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.