NPIMap

Organization Active NPI

Mercy Health-Allen Hospital LLC

Doing business as Mercy Health Allen Hospital

  • Critical Access Hospital
  • Oberlin, OH
National Provider Identifier
1801825997
Registry record updated Jun 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
Legal business name
MERCY HEALTH-ALLEN HOSPITAL LLC
Doing business as
Mercy Health Allen Hospital
Practice address
200 W Lorain St
Oberlin, OH 44074-1026
Phone
(440) 960-3983
Fax
(440) 960-3359
NPI assigned
Jul 1, 2006
Last updated
Jun 20, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
MERCY HEALTH LORAIN LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 20, 2023

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

Authorized official

Name
Kimberly M Ralston
Title
VP Reimbursement
Phone
(419) 996-5119

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X NU Primary

Addresses

Primary practice location

200 W Lorain St
Oberlin, OH 44074-1026

Mailing address

PO Box 636569
Cincinnati, OH 45263-6569
Phone (440) 960-3983

Other identifiers 1

IdentifierTypeStateIssuer
0117402MedicaidOH

Other names 1

  • Mercy Health Allen 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 OH2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20071102000482 OH Part A Provider - Critical Access Hospital 5092802389 Practice locations: Oberlin, OH
O20080731000059 OH Part B Supplier - Clinic/Group Practice 5092802389 Receives reassigned benefits from 34 practitioners
2 other NPIs on this enrollment
Practice locations: Lagrange, OH; Oberlin, OH; Wellington, OH

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1801825997. Details of each certification follow.

Hospital certification: CCN 361306

Legal name
MERCY HEALTH-ALLEN HOSPITAL LLC
Doing business as
MERCY HEALTH - ALLEN HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Sep 1, 2001
Last certification
Apr 30, 2009
Beds
25
Ownership / control type
Private (not for profit)
Organization structure
LLCNon-profit
Incorporated
Jun 24, 1959 in OH
Enrollment address
200 W Lorain St
Oberlin, OH 44074-1026
Main/Primary Hospital Location

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

Other NPIs with the same Medicare PAC ID 3

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: Hospital

Medicare Care Compare
Listed as
Mercy Allen HospitalCCN 361306 · All quality measures
Overall star rating
5 of 5
Type
Critical Access Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Part of
Community Health Partners Regional Health System

Ownership & related parties

All disclosed owners & managing parties 19

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 Non-profit, Chain home office 5% Or Greater Indirect Ownership Interest Sep 1, 2018 100%
Alexander Garvey Individual Corporate DirectorBoard Memeber 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
Kimberly M Ralston Individual W-2 Managing EmployeeVP Reimbursement Apr 7, 2005
Mercy Health Lorain LLC Organization, Lorain, OH Non-profit 5% Or Greater Direct Ownership Interest Sep 1, 2001 100%
Operational/Managerial Control Sep 1, 2001

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

Practitioners & affiliated clinicians

Practitioners 60

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 60

Affiliated clinicians 98

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

View all 98

NPI Registry JSON

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

{
    "created_epoch": "1151712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687219200000",
    "number": "1801825997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 636569",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452636569",
            "telephone_number": "440-960-3983",
            "fax_number": "440-960-3359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W LORAIN ST",
            "city": "OBERLIN",
            "state": "OH",
            "postal_code": "440741026",
            "telephone_number": "440-960-3983",
            "fax_number": "440-960-3359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCY HEALTH-ALLEN HOSPITAL LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MERCY HEALTH LORAIN LLC",
        "enumeration_date": "2006-07-01",
        "last_updated": "2023-06-20",
        "certification_date": "2023-06-20",
        "status": "A",
        "authorized_official_last_name": "RALSTON",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "VP REIMBURSEMENT",
        "authorized_official_telephone_number": "419-996-5119"
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0117402",
            "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 Allen Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Oberlin, OH

Sources for this page

Verify at the official NPI Registry.