NPIMap

Organization Active NPI

Bon Secours Memorial Regional Medical Center LLC

Doing business as Memorial Regional Medical Center

  • General Acute Care Hospital
  • Mechanicsville, VA
National Provider Identifier
1912969064
Registry record updated Sep 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
Legal business name
BON SECOURS MEMORIAL REGIONAL MEDICAL CENTER LLC
Doing business as
Memorial Regional Medical Center
Practice address
8260 Atlee Rd
Mechanicsville, VA 23116-1844
Phone
(804) 764-6000
Fax
(804) 764-6420
NPI assigned
Apr 4, 2006
Last updated
Sep 16, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2020

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

Authorized official

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

Specialties & licenses 2

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

Addresses

Primary practice location

8260 Atlee Rd
Mechanicsville, VA 23116-1844

Mailing address

PO Box 639995
Cincinnati, OH 45263-9995

Other identifiers 1

IdentifierTypeStateIssuer
4900693MedicaidVA

Other names 1

  • MEMORIAL REGIONAL MEDICAL CENTER Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

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

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1912969064. Details of each certification follow.

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
CorporationNon-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

Other NPIs with the same Medicare PAC ID 2

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Bon Secours Memorial Regional Medical CenterCCN 490069 · All quality measures
Overall star rating
4 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
Tax ID family
BS-MRMC Ta Westwood Hegrp6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

Locations

11400 N Lakeridge Pkwy
Ashland, VA 23005
Phone (804) 388-6200

8260 Atlee Rd
#1
Mechanicsville, VA 23116

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
Bon Secours Richmond, LLC Organization, Blue Ash, OH LLC 5% Or Greater Indirect Ownership Interest Dec 19, 2012 100%
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 100%
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 Sep 8, 2020
Corporate DirectorCfo Sep 8, 2020
W-2 Managing EmployeeCfo Sep 8, 2020
Mary Shimo Individual Corporate DirectorBoard Member Apr 22, 2022
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 May 30, 1998 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.

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

Affiliated clinicians 958

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

View all 958

NPI Registry JSON

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

{
    "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

Sources for this page

Verify at the official NPI Registry.