NPIMap

Organization Active NPI

Mercy Health-Regional Medical Center LLC

Doing business as Mercy Regional Medical Center

  • Psychiatric Hospital Unit
  • Lorain, OH
National Provider Identifier
1700281763
Registry record updated Dec 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric Hospital UnitTaxonomy code 273R00000X
Legal business name
MERCY HEALTH-REGIONAL MEDICAL CENTER LLC
Doing business as
Mercy Regional Medical Center
Mercy Health Behavioral Health Inpatient Services
Practice address
3700 Kolbe Rd
Lorain, OH 44053-1611
Phone
(440) 960-4740
Fax
(440) 960-4740
NPI assigned
Nov 3, 2014
Last updated
Dec 6, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
MERCY HEALTH REGIONAL MEDICAL CENTER LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 6, 2021

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

Authorized official

Name
Mr. Edwin Oley
Title
President
Phone
(440) 960-3295

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital Unit 273R00000X Primary

Addresses

Primary practice location

3700 Kolbe Rd
Lorain, OH 44053-1611

Mailing address

PO Box 636409
Cincinnati, OH 45263-6409
Phone (440) 960-4740

Other names 2

  • MERCY REGIONAL MEDICAL CENTER Doing business as
  • Mercy Health Behavioral Health Inpatient Services 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
O20150415000106 OH Part A Provider - Hospital 3577471101 Practice locations: Lorain, OH

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1700281763. Details of each certification follow.

Hospital certification: CCN 36S172

Legal name
MERCY HEALTH-REGIONAL MEDICAL CENTER LLC
Doing business as
MERCY HEALTH - BEHAVIORAL HEALTH, INPATIENT SERVICES
Organization structure
LLCNon-profit
Incorporated
Sep 22, 1927 in OH
Enrollment address
3700 Kolbe Rd
Lorain, OH 44053-1611
Hospital Psychiatric Unit
Hospital subgroups
General, Psychiatric

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

Other NPIs with the same Medicare PAC ID 4

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

National Provider Directory

National Provider Directory
Tax ID family
Lorain St Joseph Hospic7 organizations share this tax ID, including this one
Part of
Lorain St Joseph Hospic

Other organizations with this tax ID 6

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

Member organizations 2

Organizations listed as members of this organization 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
Parris Smith Individual Corporate DirectorBoard Member Jan 1, 2022
Robert L Thomas Individual Corporate DirectorBoard Member Jan 1, 2022
Michelle Crawford Individual Corporate DirectorBoard Member Jan 3, 2022
Barbara Thomas Individual Corporate DirectorBoard Member Feb 22, 2018
Kathleen Kern Individual Corporate DirectorBoard Member Jan 1, 2025
Darin Wiswell Individual Corporate DirectorBoard Member Jan 1, 2025
Bon Secours Mercy Health Inc Organization, Cincinnati, OH Corporation, Non-profit 5% Or Greater Indirect Ownership Interest Sep 1, 2018 100%
Alexander Garvey Individual Corporate DirectorBoard Member Jan 1, 2025
John Starcher Individual Operational/Managerial ControlCho Admin Feb 1, 2016
Darryl Tucker Individual Corporate DirectorBoard Member Feb 22, 2018
John Luellen Individual Corporate DirectorBoard Member Jan 1, 2022
Cindy Andrews Individual Corporate DirectorBoard Member Feb 1, 2017
Victor Leandry Individual Corporate DirectorBoard Member Feb 1, 2017
Tracy Green Individual Corporate DirectorBoard Member Feb 1, 2017
Cynthia L Dennison Individual Corporate OfficerCfo May 24, 2019
Corporate DirectorCfo May 24, 2019
W-2 Managing EmployeeCfo May 24, 2019
Randall Fortin Individual Corporate DirectorBoard Member Aug 5, 2010
Richard B White Individual Corporate DirectorBoard Member Jan 1, 2022
Donald Kline Individual Corporate DirectorBoard Member Jan 1, 2020
Kimberly M Ralston Individual W-2 Managing EmployeeVP Reimbursment Oct 7, 2017
Mercy Health Lorain LLC Organization, Lorain, OH LLC 5% Or Greater Direct Ownership Interest Nov 5, 2003 100%
Operational/Managerial Control Nov 5, 2003

Owners & managing parties with NPI records 2

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

NPI Registry JSON

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

{
    "created_epoch": "1414972800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1638748800000",
    "number": "1700281763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 636409",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452636409",
            "telephone_number": "440-960-4740",
            "fax_number": "440-960-4630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 KOLBE RD",
            "city": "LORAIN",
            "state": "OH",
            "postal_code": "440531611",
            "telephone_number": "440-960-4740",
            "fax_number": "440-960-4740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCY HEALTH-REGIONAL MEDICAL CENTER LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MERCY HEALTH REGIONAL MEDICAL CENTER LLC",
        "enumeration_date": "2014-11-03",
        "last_updated": "2021-12-06",
        "certification_date": "2021-12-06",
        "status": "A",
        "authorized_official_last_name": "OLEY",
        "authorized_official_first_name": "EDWIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "440-960-3295",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "273R00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Unit",
            "state": null,
            "license": null,
            "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 REGIONAL MEDICAL CENTER",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MERCY REGIONAL MEDICAL CENTER",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Mercy Health Behavioral Health Inpatient Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lorain, OH

Sources for this page

Verify at the official NPI Registry.