NPIMap

Organization Active NPI

Bon Secours St. Francis Medical Center LLC

  • Family Medicine Physician
  • Chester, VA
National Provider Identifier
1801173141
Registry record updated Oct 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
BON SECOURS ST. FRANCIS MEDICAL CENTER LLC
Practice address
11601 Iron Bridge Rd Ste 117
Chester, VA 23831-1467
Phone
(804) 717-5300
Fax
(804) 748-7269
NPI assigned
Nov 15, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2021

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

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

11601 Iron Bridge Rd Ste 117
Chester, VA 23831-1467

Mailing address

PO Box 639993
Cincinnati, OH 45263-9993

Other identifiers 1

IdentifierTypeStateIssuer
C09633OtherVAGROUP PTAN

Other names 1

  • BON SECOURS IRONBRIDGE FAMILY PRACTICE Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20050920000437 VA Part B Supplier - Clinic/Group Practice 0648215418 Receives reassigned benefits from 61 practitioners
21 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Chester, VA; Midlothian, VA; Powhatan, VA
O20101123001220 VA Part A Provider - Hospital 0648215418 10 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Midlothian, VA; Powhatan, VA; Chester, VA
O20190507002725 VA Part B Supplier - Mass Immunization (Roster Biller Only) 0648215418 2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Midlothian, VA; Chester, VA

Hospital certification: CCN 490136

Legal name
BON SECOURS ST FRANCIS MEDICAL CENTER LLC
Doing business as
BON SECOURS ST FRANCIS MEDICAL CENTER
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Sep 6, 2005
Last certification
Nov 10, 2014
Beds
130
Ownership / control type
Church
Organization structure
CorporationNon-profit
Incorporated
Jun 30, 1999 in VA
Enrollment address
13710 St Francis Blvd
Midlothian, VA 23114-3267
Main/Primary Hospital Location
Hospital subgroups
General, Acute care

Other NPIs on the same Medicare enrollment 22

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

View all 22

Care Compare: Hospital

Medicare Care Compare
Listed as
Bon Secours St Francis Medical CenterCCN 490136
Overall star rating
3 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Church
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Locations

13710 St Francis Blvd
Ste 502
Midlothian, VA 23114
Phone (804) 594-7428

13540 Hull Street Rd
Midlothian, VA 23112
Phone (804) 595-1400

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
Jeffrey Szyperski Individual Corporate DirectorBoard Member Jan 1, 2024
Rebecca W McDonough Individual Corporate DirectorBoard Member Jan 1, 2025
Paula P Pando Individual Corporate DirectorBoard Member Jan 1, 2025
Robert Ukrop Individual Corporate DirectorBoard Member Jan 1, 2025
Wael N Haidar Individual Corporate DirectorBoard Member Jan 1, 2023
Osman Parvaiz Individual Corporate DirectorBoard Member Jan 1, 2025
Lang R Liebman Individual Corporate DirectorBoard Member Jan 1, 2022
James Carter Individual Corporate DirectorBoard Member Jan 1, 2025
Brian Yanofchick Individual Corporate DirectorBoard Member Jan 1, 2020
Bon Secours Mercy Health Inc Organization, Cincinnati, OH Corporation, Non-profit, Chain home office 5% Or Greater Indirect Ownership Interest Sep 1, 2018 83%
John Starcher Individual Operational/Managerial ControlCho Admin Sep 1, 2018
Regina J Elbert Individual Corporate DirectorBoard Member Jan 1, 2022
Michael Quinones Individual Corporate DirectorBoard Member Jan 1, 2023
William Kusnierz Individual Corporate OfficerCfo Richmond MKT Sep 18, 2020
Corporate DirectorBoard Member Sep 18, 2020
W-2 Managing EmployeeCfo Richmond MKT Sep 18, 2020
Mary Shimo Individual Corporate DirectorBoard Member Apr 22, 2022
Bon Secours Richmond LLC Organization, Cincinnati, OH LLC, Non-profit 5% Or Greater Indirect Ownership Interest Jan 1, 2023 83%
Michael John Lutes Individual Corporate DirectorBoard Member Oct 1, 2022
Devon Henry Individual Corporate DirectorBoard Member Jan 1, 2024
Bon Secours - Richmond Health System Organization, Richmond, VA Non-profit 5% Or Greater Direct Ownership Interest Jun 30, 1999 100%
Kimberly M Ralston Individual W-2 Managing EmployeeVP Reimbursement Sep 1, 2018

Owners & managing parties with NPI records 1

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

Practitioners & affiliated clinicians

Practitioners 22

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

View all 22

Affiliated clinicians 1,086

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

View all 1,086

NPI Registry JSON

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

{
    "created_epoch": "1321315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633392000000",
    "number": "1801173141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 639993",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452639993",
            "fax_number": "866-449-0896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11601 IRON BRIDGE RD STE 117",
            "city": "CHESTER",
            "state": "VA",
            "postal_code": "238311467",
            "telephone_number": "804-717-5300",
            "fax_number": "804-748-7269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BON SECOURS ST. FRANCIS MEDICAL CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-15",
        "last_updated": "2021-10-05",
        "certification_date": "2021-10-05",
        "status": "A",
        "authorized_official_last_name": "RALSTON",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "SYSTEM DIRECTOR",
        "authorized_official_telephone_number": "419-996-5119"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP PTAN",
            "identifier": "C09633",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BON SECOURS IRONBRIDGE FAMILY PRACTICE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chester, VA

Sources for this page

Verify at the official NPI Registry.