NPIMap

Organization Active NPI

Mercy Health - Fairfield Hospital LLC

Doing business as Mercy Health Fairfield Hospital

  • Rehabilitation Hospital Unit
  • Fairfield, OH
National Provider Identifier
1598093825
Registry record updated Jan 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Hospital UnitTaxonomy code 273Y00000X
License
36T-056 Issued in OH
Legal business name
MERCY HEALTH - FAIRFIELD HOSPITAL LLC
Doing business as
Mercy Health Fairfield Hospital
Mercy Hospital Fairfield
Practice address
3000 Mack Rd
Fairfield, OH 45014-5335
Phone
(513) 870-7000
Fax
(513) 981-6118
NPI assigned
Nov 24, 2009
Last updated
Jan 25, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2022

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

Authorized official

Name
Mr. Justin Krueger
Title
President
Phone
(513) 870-7111

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Hospital Unit 273Y00000X 36T-056 OH Primary

Addresses

Primary practice location

3000 Mack Rd
Fairfield, OH 45014-5335

Mailing address

PO Box 635760
Cincinnati, OH 45263-5760
Phone (513) 870-7000

Other names 2

  • Mercy Health Fairfield Hospital Doing business as
  • Mercy Hospital Fairfield 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
O20091130000203 OH Part A Provider - Hospital 8628084985 1 other NPI on this enrollment
Practice locations: Fairfield, OH

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1598093825. Details of each certification follow.

Hospital certification: CCN 36T056

Legal name
MERCY HEALTH - FAIRFIELD HOSPITAL LLC
Doing business as
MERCY HOSPITAL FAIRFIELD-REHABILITATION UNIT
Organization structure
LLCNon-profit
Incorporated
Nov 7, 1903 in OH
Enrollment address
3000 Mack Rd
Fairfield, OH 45014-5399
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 1

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

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Inpatient rehabilitation facility

Medicare Care Compare
Listed as
Mercy Hospital FairfieldCCN 36T056 · All quality measures
Ownership
Non-profit
Certified
Jan 1, 2010

National Provider Directory

National Provider Directory
Tax ID family
Mercy South Hospital3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

12115 Sheraton Ln
#B
Cincinnati, OH 45246
Phone (513) 985-1269

2960 Mack Rd
Ste 110
Fairfield, OH 45014
Phone (513) 296-8090

2990 Mack Rd
Fairfield, OH 45014
Phone (513) 774-2880

2990 Mack Rd
Fl 1
Fairfield, OH 45014
Phone (513) 774-2880

2990 Mack Rd
Fl 2
Fairfield, OH 45014
Phone (513) 682-6900

3050 Mack Rd
Ste 100
Fairfield, OH 45014
Phone (513) 682-1212

3050 Mack Rd
Ste 110
Fairfield, OH 45014
Phone (513) 870-7101

870 NW Washington Blvd
Ste D
Hamilton, OH 45013
Phone (513) 559-7100

6770 Cincinnati Dayton Rd
Ste 105A
Liberty Township, OH 45044
Phone (513) 981-4340

6770 Cincinnati Dayton Rd
Ste 107
Liberty Township, OH 45044
Phone (513) 981-4340

6770 Cincinnati Dayton Rd
Ste 204
Liberty Township, OH 45044
Phone (513) 215-8100

280 S Locust St
Oxford, OH 45056
Phone (513) 232-6677

421 S Locust St
Oxford, OH 45056
Phone (513) 280-5600

8737 Union Centre Blvd
Ste B
West Chester, OH 45069
Phone (513) 645-2246

Ownership & related parties

All disclosed owners & managing parties 17

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

NameRoleSinceShare
Daniel Feldmann Individual Corporate DirectorBoard Member Jan 1, 2024
Mercy Health Cincinnati LLC Organization, Cincinnati, OH Non-profit 5% Or Greater Direct Ownership Interest Jul 1, 1966 100%
Janice C Jones Individual Corporate DirectorBoard Member Jan 1, 2024
Michael Bezney Individual Corporate DirectorBoard Member Jan 1, 2024
Bon Secours Mercy Health Inc Organization, Cincinnati, OH Corporation, Non-profit, Chain home office 5% Or Greater Indirect Ownership Interest Sep 1, 2018 100%
Justin R Krueger Individual Corporate OfficerPresident Jul 15, 2019
Corporate DirectorBoard Member Jul 15, 2019
W-2 Managing EmployeePresident Jul 15, 2019
Alexander Garvey Individual Corporate DirectorBoard Member Jan 1, 2023
John Starcher Individual Operational/Managerial ControlCho Admin Feb 1, 2016
John Luellen Individual Corporate DirectorBoard Member Aug 15, 2025
Eric Thiemann Individual Corporate DirectorBoard Member Jan 1, 2022
Mark O Carter Individual Corporate DirectorBoard Member Jan 1, 2022
Suzanne M Kathman Individual Corporate DirectorBoard Member Jan 1, 2019
James J McGraw Individual Corporate DirectorBoard Member Jan 1, 2024
Edward Babbitt Individual Corporate DirectorBoard Member Feb 1, 2016
Kevin J Cochran Individual Corporate DirectorBoard Member Feb 1, 2018
Vincent a Dinapoli Individual Corporate DirectorBoard Member Feb 1, 2018
Kimberly M Ralston Individual W-2 Managing EmployeeVP Reimbursment Apr 7, 2005

Owners & managing parties with NPI records 3

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 11

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 6

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": "1259020800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643068800000",
    "number": "1598093825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 635760",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452635760",
            "telephone_number": "513-870-7000",
            "fax_number": "513-981-6118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 MACK RD",
            "city": "FAIRFIELD",
            "state": "OH",
            "postal_code": "450145335",
            "telephone_number": "513-870-7000",
            "fax_number": "513-981-6118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCY HEALTH - FAIRFIELD HOSPITAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-24",
        "last_updated": "2022-01-25",
        "certification_date": "2022-01-25",
        "status": "A",
        "authorized_official_last_name": "KRUEGER",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "513-870-7111",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "273Y00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Unit",
            "state": "OH",
            "license": "36T-056",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Fairfield Hospital",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Mercy Hospital Fairfield",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Mercy Hospital Fairfield",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fairfield, OH

Sources for this page

Verify at the official NPI Registry.