NPIMap

Organization Active NPI

Maryview Hospital LLC

  • Rehabilitation Hospital Unit
  • Portsmouth, VA
National Provider Identifier
1922018092
Registry record updated Oct 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Hospital UnitTaxonomy code 273Y00000X
License
H 1830 Issued in VA
Legal business name
MARYVIEW HOSPITAL LLC
Practice address
3636 High St
Portsmouth, VA 23707-3236
Phone
(757) 398-4160
Fax
(757) 393-1437
NPI assigned
Aug 9, 2006
Organization subpart
Yes
Parent organization
MARYVIEW HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 22, 2020

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
Rehabilitation Hospital Unit 273Y00000X H 1830 VA Primary

Addresses

Primary practice location

3636 High St
Portsmouth, VA 23707-3236

Mailing address

PO Box 639898
Cincinnati, OH 45263-9898
Phone (513) 952-5002

Other identifiers 1

IdentifierTypeStateIssuer
4930100MedicaidVA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130625000149 VA Part A Provider - Hospital 5799685632 Practice locations: Portsmouth, VA

Hospital certification: CCN 49T017

Legal name
MARYVIEW HOSPITAL LLC
Doing business as
MARYVIEW HOSPITAL
Organization structure
CorporationNon-profit
Incorporated
Sep 22, 1944 in VA
Enrollment address
3636 High Street
Portsmouth, VA 23707-3236
Hospital Rehabilitation Unit
Hospital subgroups
Rehabilitation unit

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

Other NPIs with the same Medicare PAC ID 5

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

Care Compare: Inpatient rehabilitation facility

Medicare Care Compare
Listed as
Maryview Center for Physical RehabilitationCCN 49T017
Ownership
Non-profit
Certified
Jun 17, 2002

National Provider Directory

National Provider Directory
Part of
Maryview Health Care Ce

Ownership & related parties

All disclosed owners & managing parties 18

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Ann M Kirk Individual Corporate DirectorBoard Member Jan 1, 2025
Kevin Clark Individual Corporate DirectorBoard Member Jan 1, 2026
Angela Reddix Individual Corporate DirectorBoard Member Jan 1, 2026
Patricia Davis-Hagens Individual Corporate DirectorBoard Member Oct 18, 2021
David a Cannady Individual Corporate DirectorBoard Member Jan 1, 2023
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
Dawn Glynn Individual Corporate DirectorBoard Member Jan 1, 2024
Bon Secours Hampton Roads Health System Inc Organization, Suffolk, VA Non-profit 5% Or Greater Direct Ownership Interest Jan 24, 1985 100%
Corey McCray Individual Corporate DirectorBoard Member Jan 1, 2024
Raymond L McCue Individual Corporate DirectorBoard Member Jan 1, 2026
Teresa Beale Individual Corporate DirectorBoard Member Jan 1, 2022
Jonathan L Haynes Individual Corporate OfficerCfo Hampton Market Jan 1, 2022
Corporate DirectorBoard Member Jan 1, 2022
W-2 Managing EmployeeCfo Hampton Market Jan 1, 2022
John E Snellings Individual Corporate DirectorBoard Member Jan 1, 2026
Cynthia C Romero Individual Corporate DirectorBoard Member Jan 1, 2016
Kimberly M Ralston Individual W-2 Managing EmployeeVP Reimbursement Sep 1, 2018
Joy L Jefferson Individual Corporate DirectorBoard Member Jan 1, 2025

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

Affiliated clinicians 3

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

NPI Registry JSON

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

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603324800000",
    "number": "1922018092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 639898",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452639898",
            "telephone_number": "513-952-5002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3636 HIGH ST",
            "city": "PORTSMOUTH",
            "state": "VA",
            "postal_code": "237073236",
            "telephone_number": "757-398-4160",
            "fax_number": "757-393-1437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARYVIEW HOSPITAL LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MARYVIEW HOSPITAL",
        "enumeration_date": "2006-08-09",
        "last_updated": "2020-10-22",
        "certification_date": "2020-10-22",
        "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": "273Y00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Unit",
            "state": "VA",
            "license": "H 1830",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4930100",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portsmouth, VA

Sources for this page

Verify at the official NPI Registry.