NPIMap

Organization Active NPI

Vibra Hospital of Western Massachusetts, LLC

  • Long Term Care Hospital
  • Rochdale, MA
National Provider Identifier
1699192203
Registry record updated Dec 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care HospitalTaxonomy code 282E00000X
Legal business name
VIBRA HOSPITAL OF WESTERN MASSACHUSETTS, LLC
Practice address
111 Huntoon Memorial Hwy
1St Floor
Rochdale, MA 01542-1305
Phone
(508) 892-6000
Fax
(508) 892-6001
NPI assigned
Mar 20, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2017

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

Authorized official

Name
Mr. Brad E. Hollinger
Title
President
Phone
(717) 591-5700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Long Term Care Hospital 282E00000X Primary

Addresses

Primary practice location

111 Huntoon Memorial Hwy
1St Floor
Rochdale, MA 01542-1305

Mailing address

4499 Acushnet Avenue
New Bedford, MA 02745-4707
Phone (508) 995-6900

Other names 1

  • Vibra Hospital of Western Massachusetts-Central Campus Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140102000452 MA Part A Provider - Hospital 2365684149 2 other NPIs on this enrollment
Practice locations: Rochdale, MA

Hospital certification: CCN 222046

Legal name
VIBRA HOSPITAL OF WESTERN MASSACHUSETTS LLC
Doing business as
VIBRA HOSPITAL OF WESTERN MASSACHUSETTS
Certification status
Active
Provider type (POS)
Hospital – Long-term
Participating since
Apr 13, 2001
Last certification
May 7, 2015
Beds
174
Ownership / control type
Private (for profit)
Most recent change of ownership
Sep 1, 2013 (1 total)
Organization structure
LLCProprietary
Incorporated
Apr 23, 2013 in DE
Enrollment address
111 Huntoon Memorial Hwy
FL 1
Rochdale, MA 15421305
Main/Primary Hospital Location
Hospital subgroups
Long-term

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 2

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

Care Compare: Long-term care hospital

Medicare Care Compare
Listed as
Vibra Hospital of Western Mass - Central CampusCCN 222046
Ownership
For profit
Certified
Apr 13, 2001
Medicare certification status
ActiveFrom the Provider of Services file
Beds
174

National Provider Directory

National Provider Directory

Locations

111 Huntoon Memorial Hwy
#1
Rochdale, MA 01542
Phone (508) 892-6000

Ownership & related parties

All disclosed owners & managing parties 11

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

NameRoleSinceShare
Babacar Diop Individual W-2 Managing EmployeeCeo May 10, 2021 100%
Marie Yigle-Kaljob Individual W-2 Managing EmployeeChief Executive Officer Aug 30, 2021
Vibra Holdings One LLC Organization, Mechanicsburg, PA LLC, Holding company, For-profit Other Sep 1, 2013
Kelly M Hollinger Individual Corporate OfficerVice President Mar 1, 2020
MPT of Rochdale - Vibra, LLC Organization, Vestavia, AL Created for acquisition, LLC, Investment firm, For-profit 5% Or Greater Security Interest Aug 30, 2019 100%
Credit Suisse Ag Organization, New York, NY LLC, Financial institution, For-profit 5% Or Greater Security Interest Jul 22, 2020
David E Hauck Individual Corporate OfficerOfficer Oct 4, 2018
Nathan I Arbouet Individual W-2 Managing EmployeeCeo Dec 15, 2014
Vibra Healthcare II, LLC Organization, Mechanicsburg, PA LLC, Holding company, For-profit 5% Or Greater Indirect Ownership Interest Sep 1, 2013 100%
Trisha J Niemuth Individual Corporate OfficerVP/Sec Jan 1, 2022
Brad E Hollinger Individual 5% Or Greater Indirect Ownership Interest Sep 1, 2013 77%
Corporate OfficerPresident Sep 1, 2013

Facilities with the same owner 4

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

Practitioners & affiliated clinicians

Practitioners 4

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

Affiliated clinicians 4

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": "1395273600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1512691200000",
    "number": "1699192203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4499 ACUSHNET AVENUE",
            "city": "NEW BEDFORD",
            "state": "MA",
            "postal_code": "027454707",
            "telephone_number": "508-995-6900",
            "fax_number": "508-998-5974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 HUNTOON MEMORIAL HWY",
            "address_2": "1ST FLOOR",
            "city": "ROCHDALE",
            "state": "MA",
            "postal_code": "015421305",
            "telephone_number": "508-892-6000",
            "fax_number": "508-892-6001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIBRA HOSPITAL OF WESTERN MASSACHUSETTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-20",
        "last_updated": "2017-12-08",
        "status": "A",
        "authorized_official_last_name": "HOLLINGER",
        "authorized_official_first_name": "BRAD",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "717-591-5700",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "282E00000X",
            "taxonomy_group": "",
            "desc": "Long Term Care Hospital",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vibra Hospital of Western Massachusetts-Central Campus",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rochdale, MA

Sources for this page

Verify at the official NPI Registry.