NPIMap

Organization Active NPI

Bon Secours Mercy Health Franklin LLC

Doing business as Bon Secours - Southampton Long Term Care and Skilled Nursing Care

  • Skilled Nursing Facility
  • Franklin, VA
National Provider Identifier
1649815770
Registry record updated Nov 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
BON SECOURS MERCY HEALTH FRANKLIN LLC
Doing business as
Bon Secours - Southampton Long Term Care and Skilled Nursing Care
Practice address
100 Fairview Dr
Franklin, VA 23851-1238
Phone
(757) 569-6100
NPI assigned
Nov 13, 2019
Last updated
Nov 23, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2020

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

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

100 Fairview Dr
Franklin, VA 23851-1238

Mailing address

PO Box 639857
Cincinnati, OH 45263-9857
Phone (419) 996-5119

Other names 1

  • BON SECOURS - SOUTHAMPTON LONG TERM CARE AND SKILLED NURSING CARE Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200108000922 VA Part A Provider - Skilled Nursing Facility 9436583242 Practice locations: Franklin, VA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1649815770. Details of each certification follow.

Skilled nursing facility certification: CCN 495157

Legal name
BON SECOURS MERCY HEALTH FRANKLIN LLC
Doing business as
BON SECOURS - SOUTHAMPTON LONG TERM CARE AND SKILLED NURSING CARE
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF distinct part
Participating since
Dec 2, 1985
Last certification
Sep 22, 2023
Beds
129
Ownership / control type
Church Related
Multi-facility organization
BON SECOURS MERCY HEALTH
Most recent change of ownership
Jan 1, 2020
Organization structure
LLCNon-profit
Enrollment address
100 Fairview Dr
Franklin, VA 23851-1238
Nursing home name
SOUTHAMPTON MEMORIAL HOSP

Other NPIs with the same Medicare PAC ID 2

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

Care Compare: Nursing home

Medicare Care Compare
Listed as
Southampton Memorial HospCCN 495157 · All quality measures
Overall star rating
5 of 5
Health inspections
4 of 5
Staffing
5 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Church related
Certified
Dec 2, 1985
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
12987.5 residents per day on average

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Tax ID family
Bon Secours Mercy Health Franklin LLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Ownership & related parties

All disclosed owners & managing parties 20

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

NameRoleSinceShare
Deborah a Russell Individual Corporate DirectorBoard Member Jan 1, 2023
Trustee of the SNF Jan 1, 2023
Alex Zawoloka Individual Corporate DirectorMedical Director Jan 1, 2025
Adp of the SNF Jul 17, 2025
Ann M Kirk Individual Corporate DirectorBoard Member Jan 1, 2025
Trustee of the SNF Jan 1, 2025
Carolyn M Rutledge Individual Corporate DirectorBoard Member Jan 1, 2023
Trustee of the SNF Jan 1, 2023
Charlette Fairchild Individual Corporate DirectorBoard Member Jan 1, 2020
Trustee of the SNF Jan 1, 2020
Amir Hajimomenian Individual Corporate OfficerMedical Administrator Jan 1, 2025
Managing Control - Governing BodyMedical Administrator Jan 1, 2025
Adp of the SNF Jul 17, 2025
Diane Suber Individual Corporate DirectorBoard Member Jan 1, 2023
Trustee of the SNF Jan 1, 2023
Patricia Davis-Hagens Individual Corporate DirectorBoard Member Oct 18, 2021
Trustee of the SNF Oct 18, 2022
David a Cannady Individual Corporate DirectorBoard Member Jan 1, 2023
Trustee of the SNF Jan 1, 2023
Brian Yanofchick Individual Corporate DirectorBoard Member Jan 1, 2020
Trustee of the SNF Jan 1, 2020
Bon Secours Mercy Health Inc Organization, Cincinnati, OH Corporation, Non-profit, Chain home office 5% Or Greater Indirect Ownership Interest Jan 1, 2020 100%
Adp of the SNF Mar 28, 2025
Indirect Ownership Interest Jan 1, 2020 100%
John Starcher Individual Adp of the SNF Jan 1, 2025
Dawn Glynn Individual Corporate DirectorBoard Member Jan 1, 2024
Trustee of the SNF Jan 1, 2024
Bon Secours Hampton Roads Health System Inc Organization, Suffolk, VA LLC, Non-profit, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Jan 1, 2020 100%
Direct Ownership Interest Jan 1, 2020 100%
Corey McCray Individual Corporate DirectorBoard Member Jan 1, 2024
Trustee of the SNF Jan 1, 2024
Teresa Beale Individual Corporate DirectorBoard Member Jan 1, 2022
Trustee of the SNF Jan 1, 2022
Jonathan L Haynes Individual Corporate OfficerCfo Hampton MKT Jan 1, 2022
Corporate DirectorBoard Member Jan 1, 2022
Operational/Managerial Control Jan 1, 2020
Trustee of the SNF Jan 1, 2022
Edward F Gerardo Individual Corporate DirectorBoard Member Jan 1, 2023
Trustee of the SNF Jan 1, 2023
Cynthia C Romero Individual Corporate DirectorBoard Member Jan 1, 2020
Trustee of the SNF Jan 1, 2020
Joy L Jefferson Individual Corporate DirectorBoard Member Jan 1, 2025
Trustee of the SNF Jan 1, 2025

Owners & managing parties with NPI records 4

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

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": "1573603200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1606089600000",
    "number": "1649815770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 639857",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452639857",
            "telephone_number": "419-996-5119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 FAIRVIEW DR",
            "city": "FRANKLIN",
            "state": "VA",
            "postal_code": "238511238",
            "telephone_number": "757-569-6100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BON SECOURS MERCY HEALTH FRANKLIN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-13",
        "last_updated": "2020-11-23",
        "certification_date": "2020-11-23",
        "status": "A",
        "authorized_official_last_name": "RALTON",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "SYSTEM DIRECTOR",
        "authorized_official_telephone_number": "419-996-5119"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BON SECOURS - SOUTHAMPTON LONG TERM CARE AND SKILLED NURSING CARE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Franklin, VA

Sources for this page

Verify at the official NPI Registry.