NPIMap

Organization Active NPI

Bon Secours St. Francis Medical Center LLC

Doing business as Powhatan Medical Associates

  • Family Medicine Physician
  • Powhatan, VA
National Provider Identifier
1891071965
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
Doing business as
Powhatan Medical Associates
Practice address
3452 Anderson Hwy Ste D
Powhatan, VA 23139-5845
Phone
(804) 285-6050
Fax
(804) 598-2481
NPI assigned
Nov 2, 2011
Last updated
Oct 5, 2021By the provider in NPPES
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
Joseph Hardy
Title
Cfo
Phone
(513) 869-5016

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary
Pediatrics Physician 208000000X NU

Addresses

Primary practice location

3452 Anderson Hwy Ste D
Powhatan, VA 23139-5845

Mailing address

8580 Magellan Pkwy
Richmond, VA 23227-1149

Other identifiers 1

IdentifierTypeStateIssuer
C09633OtherVAGROUP PTAN

Other names 1

  • Powhatan Medical Associates Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA2 enrollments

Enrollment records 2

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

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1891071965. Details of each certification follow.

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 · All quality measures
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

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 5

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.

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": "1320192000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633392000000",
    "number": "1891071965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8580 MAGELLAN PKWY",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232271149",
            "fax_number": "866-449-0896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3452 ANDERSON HWY STE D",
            "city": "POWHATAN",
            "state": "VA",
            "postal_code": "231395845",
            "telephone_number": "804-285-6050",
            "fax_number": "804-598-2481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BON SECOURS ST. FRANCIS MEDICAL CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-02",
        "last_updated": "2021-10-05",
        "certification_date": "2021-10-05",
        "status": "A",
        "authorized_official_last_name": "HARDY",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "513-869-5016"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP PTAN",
            "identifier": "C09633",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Powhatan Medical Associates",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Powhatan Medical Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Powhatan, VA

Sources for this page

Verify at the official NPI Registry.