NPIMap

Mercy Health - Fairfield Hospital LLC

Organization Active NPI Rehabilitation Hospital Unit · Fairfield, OH

NPI 1598093825 · NPPES record last updated Jan 25, 2022

Key facts

NPI
1598093825
Entity type
Organization (NPI type 2)
Primary specialty
Rehabilitation Hospital Unit 273Y00000X
License
36T-056 (OH)
Legal business name
MERCY HEALTH - FAIRFIELD HOSPITAL LLC
Practice address
3000 Mack Rd
Fairfield, OH 45014-5335
Phone
(513) 870-7000
Fax
(513) 981-6118
NPI assigned
Nov 24, 2009
Organization subpart
No

Authorized official

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

Owners & managing parties with NPI records 3

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

Other NPIs on the same Medicare enrollment 1

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

Other NPIs with the same Medicare PAC ID 1

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

Corporate family (same tax ID) 2

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

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

Facilities with the same owner 97

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

View all 97

Practitioners 10

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

Affiliated clinicians 6

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

Medicare Care Compare: Inpatient rehabilitation facility

Listed as
Mercy Hospital Fairfield CCN 36T056
Ownership
Non-profit
Certified
Jan 1, 2010

Source: Medicare Care Compare.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in OH

Hospital certification: CCN 36T056

Legal name
MERCY HEALTH - FAIRFIELD HOSPITAL LLC
Doing business as
MERCY HOSPITAL FAIRFIELD-REHABILITATION UNIT
Organization structure
LLC · Non-profit
Incorporated
Nov 7, 1903 in OH
Enrollment address
3000 Mack Rd
Fairfield, OH 45014-5399
Hospital Rehabilitation Unit
Hospital subgroups
Rehabilitation unit

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 Director
Board 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 Director
Board Member		 Jan 1, 2024
Michael Bezney
Individual 		Corporate Director
Board 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 Officer
President		 Jul 15, 2019
Corporate Director
Board Member		 Jul 15, 2019
W-2 Managing Employee
President		 Jul 15, 2019
Alexander Garvey
Individual 		Corporate Director
Board Member		 Jan 1, 2023
John Starcher
Individual 		Operational/Managerial Control
Cho Admin		 Feb 1, 2016
John Luellen
Individual 		Corporate Director
Board Member		 Aug 15, 2025
Eric Thiemann
Individual 		Corporate Director
Board Member		 Jan 1, 2022
Mark O Carter
Individual 		Corporate Director
Board Member		 Jan 1, 2022
Suzanne M Kathman
Individual 		Corporate Director
Board Member		 Jan 1, 2019
James J McGraw
Individual 		Corporate Director
Board Member		 Jan 1, 2024
Edward Babbitt
Individual 		Corporate Director
Board Member		 Feb 1, 2016
Kevin J Cochran
Individual 		Corporate Director
Board Member		 Feb 1, 2018
Vincent a Dinapoli
Individual 		Corporate Director
Board Member		 Feb 1, 2018
Kimberly M Ralston
Individual 		W-2 Managing Employee
VP Reimbursment		 Apr 7, 2005

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20091130000203 OH Part a Provider - Hospital 8628084985 1 other NPI on this enrollment
Practice locations: Fairfield, OH

National Provider Directory

Tax ID family
Mercy South Hospital (3 organizations share this tax ID)

Locations

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

3050 Mack Rd
Ste 325
Fairfield, OH 45014
Phone (513) 682-6970

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

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

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

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

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

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

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

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

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

7777 University Dr
Ste B
West Chester, OH 45069

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

Specialties & licenses

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

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 identifiers

IdentifierTypeStateIssuer
5887278MedicaidOH

Other names

  • Mercy Health Fairfield Hospital Doing business as
  • Mercy Hospital Fairfield Doing business as

Electronic endpoints

TypeEndpointUseAffiliation
CONNECT URL https://172.254.9.13:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other BLUEMARK

Other providers in Fairfield, OH

All providers in Fairfield, OH · Rehabilitation Hospital Unit in Ohio

Sources for this page

Verify at the official NPI Registry.