NPIMap

Organization Active NPI

Mercy Health Youngstown LLC

Doing business as Mercy Health St Joseph Warren Hospital

  • General Acute Care Hospital
  • Warren, OH
National Provider Identifier
1629009964
Registry record updated Jan 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
Legal business name
MERCY HEALTH YOUNGSTOWN LLC
Doing business as
Mercy Health St Joseph Warren Hospital
Practice address
667 Eastland Ave SE
Warren, OH 44484-4503
Phone
(330) 841-4000
Fax
(330) 884-7091
NPI assigned
Jul 5, 2006
Last updated
Jan 26, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2022

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

Authorized official

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital Unit 273R00000X OH
General Acute Care Hospital 282N00000X OH Primary

Addresses

Primary practice location

667 Eastland Ave SE
Warren, OH 44484-4503

Mailing address

PO Box 636469
Cincinnati, OH 45263-6469
Phone (330) 306-5010

Other identifiers 14

IdentifierTypeStateIssuer
02-0903950OtherOHPHARMACY
1007751650011OtherOHMAPA
000000156989OtherOHANTHEM
145898OtherMAMMOGRAPHY
000000073247OtherOHUNISON
244548000OtherOHMAGELLAN
3600341782OtherCLIA (CMS)
5000133OtherOHUNITED HEALTH CARE
0265547MedicaidOH
3500219OtherOHUNITED HEALTH CARE
366077000OtherOHUS DEPT OF LABOR
1036195OtherOHGATEWAY-OH
6461115OtherOHAETNA
000000155282OtherOHANTHEM

Other names 1

  • MERCY HEALTH ST JOSEPH WARREN HOSPITAL 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
O20050825000143 OH Part A Provider - Hospital 7517860489 1 other NPI on this enrollment
Practice locations: Warren, OH; Youngstown, OH

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1629009964. Details of each certification follow.

Hospital certification: CCN 360161

Legal name
MERCY HEALTH YOUNGSTOWN, LLC
Doing business as
MH ST JOSEPH WARREN HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Mar 21, 2019
Beds
219
Ownership / control type
Private (not for profit)
Most recent change of ownership
Jan 1, 1996 (1 total)
Organization structure
LLCNon-profit
Incorporated
Mar 3, 1926 in OH
Enrollment address
667 Eastland Ave SE
Warren, OH 44484-4503
Main/Primary Hospital Location
Hospital subgroups
General, Acute care, Psychiatric unit

Other NPIs with the same Medicare PAC ID 4

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: Hospital

Medicare Care Compare
Listed as
MH St Joseph Warren HospitalCCN 360161 · All quality measures
Overall star rating
3 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
HM Health Services SE28 organizations share this tax ID, including this one

Other organizations with this tax ID 27

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

View all 27

Ownership & related parties

All disclosed owners & managing parties 16

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

NameRoleSinceShare
Germaine G Bennett Individual Corporate DirectorBoard Member Jan 1, 2019
Martha Bushey Individual Corporate DirectorBoard Member Jan 1, 2025
Carla Baldwin Individual Corporate DirectorBoard Member Jan 1, 2026
Michelle Crawford Individual Corporate OfficerCfo Youngstown Jan 1, 2021
Corporate DirectorBoard Member Jan 1, 2021
W-2 Managing EmployeeCfo Youngstown Jan 1, 2021
Mildred Ely Individual Corporate DirectorBoard Member Feb 1, 2018
Joseph L Mosca Individual Corporate DirectorBoard Member Jan 1, 2020
Bon Secours Mercy Health Inc Organization, Cincinnati, OH Corporation, Non-profit, Chain home office 5% Or Greater Direct Ownership Interest Jan 1, 2020 100%
John Starcher Individual Operational/Managerial ControlCho Admin Jan 1, 2016
Lewis Macklin Individual Corporate DirectorBoard Member Feb 1, 2018
John Luellen Individual Corporate DirectorBoard Member Nov 14, 2018
Juan Santiago Individual Corporate DirectorBoard Member Jan 1, 2023
Rachel Hrbolich Individual Corporate DirectorBoard Member Jan 1, 2024
Jessica Simon Individual Corporate DirectorBoard Member Jan 1, 2023
Erin Bishop Individual Corporate DirectorBoard Member Jan 1, 2024
Edward Novosel Individual Corporate DirectorBoard Member Jan 1, 2020
Kimberly M Ralston Individual W-2 Managing EmployeeVP Reimbursement Oct 7, 2017

All facility ownership & control disclosures 12

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Mercy Health Rehabilitation HospitalYoungstown, OH, CCN 363049 Hospital 5% Or Greater Direct Ownership Interest (50%) Nov 19, 2024
Bon Secours Home HealthRichmond, VA, CCN 497026C Home health agency 5% Or Greater Indirect Ownership Interest (14.24%) May 1, 2024
Mercy Health - Home Care PaducahPaducah, KY, CCN 187100 Home health agency 5% Or Greater Indirect Ownership Interest (14.24%) Apr 23, 2024
Mercy Health Home Health LimaLima, OH, CCN 367417 Home health agency 5% Or Greater Indirect Ownership Interest (14.24%) Apr 23, 2024
Mercy Health Home Care by CompassusTiffin, OH, CCN 367523 Home health agency 5% Or Greater Indirect Ownership Interest (14.24%) Apr 23, 2024
Mercy Health Home Care Lorain CountyLorain, OH, CCN 367218 Home health agency 5% Or Greater Indirect Ownership Interest (14.24%) Apr 23, 2024
Bon Secours Home Care by CompassusSun City Center, FL, CCN 109645 Home health agency 5% Or Greater Indirect Ownership Interest (14.24%) Jul 1, 2024
Bon Secours Hospice and Palliative CareRichmond, VA, CCN 491514 Hospice 5% Or Greater Indirect Ownership Interest (14.24%) May 1, 2024
Mercy Health - Hospice, LimaLima, OH, CCN 361543 Hospice 5% Or Greater Indirect Ownership Interest (14.24%) Apr 23, 2024
Mercy Health Hospice by CompassusMetropolis, IL, CCN 141548 Hospice 5% Or Greater Indirect Ownership Interest (14.24%) Apr 23, 2024
Mercy Health Home Care by CompassusLorain, OH, CCN 361563 Hospice 5% Or Greater Indirect Ownership Interest (15.29%) Apr 23, 2024
Mercy Health- Hospice PaducahPaducah, KY, CCN 181507 Hospice 5% Or Greater Indirect Ownership Interest (15.29%) Apr 23, 2024

Owned or controlled facilities with NPI records 13

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

View all 13

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 53

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.

View all 53

Affiliated clinicians 541

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

View all 541

NPI Registry JSON

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643155200000",
    "number": "1629009964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 636469",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452636469",
            "telephone_number": "330-306-5010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "667 EASTLAND AVE SE",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "444844503",
            "telephone_number": "330-841-4000",
            "fax_number": "330-884-7091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCY HEALTH YOUNGSTOWN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-05",
        "last_updated": "2022-01-26",
        "certification_date": "2022-01-26",
        "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"
    },
    "taxonomies": [
        {
            "code": "273R00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Unit",
            "state": "OH",
            "license": null,
            "primary": false
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "OH",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACY",
            "identifier": "02-0903950",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAPA",
            "identifier": "1007751650011",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000156989",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMMOGRAPHY",
            "identifier": "145898",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNISON",
            "identifier": "000000073247",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN",
            "identifier": "244548000",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA (CMS)",
            "identifier": "3600341782",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "5000133",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0265547",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "3500219",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US DEPT OF LABOR",
            "identifier": "366077000",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GATEWAY-OH",
            "identifier": "1036195",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "6461115",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000155282",
            "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 ST JOSEPH WARREN HOSPITAL",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Warren, OH

Sources for this page

Verify at the official NPI Registry.