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Bon Secours Memorial Regional Medical Center LLC

Organization Active NPI General Acute Care Hospital · Mechanicsville, VA

NPI 1912969064 · NPPES record last updated Sep 16, 2020

Key facts

NPI
1912969064
Entity type
Organization (NPI type 2)
Primary specialty
General Acute Care Hospital 282N00000X
Legal business name
BON SECOURS MEMORIAL REGIONAL MEDICAL CENTER LLC
Practice address
8260 Atlee Rd
Mechanicsville, VA 23116-1844
Phone
(804) 764-6000
Fax
(804) 764-6420
NPI assigned
Apr 4, 2006
Organization subpart
No

Authorized official

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

Owners & managing parties with NPI records 1

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

Other NPIs with the same Medicare PAC ID 2

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

Corporate family (same tax ID) 5

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

Facilities with the same owner 97

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

View all 97

Practitioners 15

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

Affiliated clinicians 958

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

View all 958

Medicare Care Compare: Hospital

Listed as
Bon Secours Memorial Regional Medical Center CCN 490069
Overall star rating
★★★★☆ 4 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Church
Medicare certification status
Active (Provider of Services file)
Emergency services
Yes

Source: Medicare Care Compare.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in VA

Hospital certification: CCN 490069

Legal name
BON SECOURS MEMORIAL REGIONAL MEDICAL CENTER LLC
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Jan 5, 2011
Beds
269
Ownership / control type
Church
Organization structure
Corporation · Non-profit
Incorporated
Aug 24, 1994 in VA
Enrollment address
8260 Atlee Rd
Mechanicsville, VA 23116-1844
Main/Primary Hospital Location
Hospital subgroups
General, Acute care

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 Director
Board Member		 Jan 1, 2024
Rebecca W McDonough
Individual 		Corporate Director
Board Member		 Jan 1, 2025
Paula P Pando
Individual 		Corporate Director
Board Member		 Jan 1, 2025
Robert Ukrop
Individual 		Corporate Director
Board Member		 Jan 1, 2025
Wael N Haidar
Individual 		Corporate Director
Board Member		 Jan 1, 2023
Osman Parvaiz
Individual 		Corporate Director
Board Member		 Jan 1, 2025
Bon Secours Richmond, LLC
Organization · Blue Ash, OH
LLC 		5% Or Greater Indirect Ownership Interest Dec 19, 2012 100%
Lang R Liebman
Individual 		Corporate Director
Board Member		 Jan 1, 2022
James Carter
Individual 		Corporate Director
Board Member		 Jan 1, 2025
Brian Yanofchick
Individual 		Corporate Director
Board 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 100%
John Starcher
Individual 		Operational/Managerial Control
Cho Admin		 Sep 1, 2018
Regina J Elbert
Individual 		Corporate Director
Board Member		 Jan 1, 2022
Michael Quinones
Individual 		Corporate Director
Board Member		 Jan 1, 2023
William Kusnierz
Individual 		Corporate Officer
Cfo		 Sep 8, 2020
Corporate Director
Cfo		 Sep 8, 2020
W-2 Managing Employee
Cfo		 Sep 8, 2020
Mary Shimo
Individual 		Corporate Director
Board Member		 Apr 22, 2022
Michael John Lutes
Individual 		Corporate Director
Board Member		 Oct 1, 2022
Devon Henry
Individual 		Corporate Director
Board Member		 Jan 1, 2024
Bon Secours - Richmond Health System
Organization · Richmond, VA
Non-profit 		5% Or Greater Direct Ownership Interest May 30, 1998 100%
Kimberly M Ralston
Individual 		W-2 Managing Employee
VP Reimbursement		 Sep 1, 2018

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20110112000292 VA Part a Provider - Hospital 6507775293 Practice locations: Richmond, VA; King William, VA; Mechanicsville, VA; Glen Allen, VA; Ashland, VA

National Provider Directory

Tax ID family
Bon Secours - Memorial Regional Medical Center Inc (6 organizations share this tax ID)

Locations

8260 Atlee Rd
#1
Mechanicsville, VA 23116

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X H1721 VA
General Acute Care Hospital 282N00000X Yes

Addresses

Primary practice location

8260 Atlee Rd
Mechanicsville, VA 23116-1844

Mailing address

PO Box 639995
Cincinnati, OH 45263-9995

Other identifiers

IdentifierTypeStateIssuer
4900693MedicaidVA

Other names

  • MEMORIAL REGIONAL MEDICAL CENTER Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Sep 16, 2020.

{
    "created_epoch": "1144108800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600214400000",
    "number": "1912969064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 639995",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452639995",
            "fax_number": "866-449-0896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8260 ATLEE RD",
            "city": "MECHANICSVILLE",
            "state": "VA",
            "postal_code": "231161844",
            "telephone_number": "804-764-6000",
            "fax_number": "804-764-6420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BON SECOURS MEMORIAL REGIONAL MEDICAL CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-04",
        "last_updated": "2020-09-16",
        "certification_date": "2020-09-16",
        "status": "A",
        "authorized_official_last_name": "RALSTON",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "SYSTEM DIRECTOR",
        "authorized_official_telephone_number": "419-996-5119"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "VA",
            "license": "H1721",
            "primary": false
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4900693",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MEMORIAL REGIONAL MEDICAL CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mechanicsville, VA

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Sources for this page

Verify at the official NPI Registry.