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Organization Active NPI

Bon Secours St. Mary's Hospital of Richmond LLC

Doing business as Bon Secours St Mary's Hospital

  • General Acute Care Hospital
  • Richmond, VA
National Provider Identifier
1962464016
Registry record updated Sep 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
Legal business name
BON SECOURS ST. MARY'S HOSPITAL OF RICHMOND LLC
Doing business as
Bon Secours St Mary's Hospital
Practice address
5801 Bremo Rd
Richmond, VA 23226-1907
Phone
(804) 285-2011
Fax
(804) 285-8327
NPI assigned
Apr 4, 2006
Last updated
Sep 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 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 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X H1723 VA
General Acute Care Hospital 282N00000X Primary

Addresses

Primary practice location

5801 Bremo Rd
Richmond, VA 23226-1907

Mailing address

PO Box 639994
Cincinnati, OH 45263-9994

Other identifiers 1

IdentifierTypeStateIssuer
4900596MedicaidVA

Other names 1

  • Bon Secours St Mary's Hospital Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040324000566 VA Part B Supplier - Clinic/Group Practice 8527969476 Receives reassigned benefits from 159 practitioners
48 other NPIs on this enrollment
Practice locations: Richmond, VA; Midlothian, VA; Mechanicsville, VA; Chester, VA; Blackstone, VA
O20091002000331 VA Part A Provider - Hospital 8527969476 5 other NPIs on this enrollment

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1962464016. Details of each certification follow.

Hospital certification: CCN 490059

Legal name
BON SECOURS ST MARYS HOSPITAL OF RICHMOND LLC
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Nov 21, 2014
Beds
391
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Aug 30, 1961 in VA
Enrollment address
5801 Bremo Rd
Richmond, VA 23226-1907
Main/Primary Hospital Location
Hospital subgroups
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).

Other NPIs on the same Medicare enrollment 53

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 53

Care Compare: Hospital

Medicare Care Compare
Listed as
Bon Secours St Marys HospitalCCN 490059 · All quality measures
Overall star rating
5 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
Bon Secours St Marys Hospital21 organizations share this tax ID, including this one

Other organizations with this tax ID 20

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

View all 20

Locations

10150 Staples Mill Rd
Ste A
Glen Allen, VA 23060
Phone (804) 893-8627

13700 St Francis Blvd
Ste 600
Midlothian, VA 23114
Phone (804) 794-6400

1850 Pocahontas Trl
Fl 2
Quinton, VA 23141

12320 W Broad St
Ste 203
Richmond, VA 23233
Phone (804) 923-7369

5855 Bremo Rd
Ste 208
Richmond, VA 23226
Phone (804) 287-7574

5875 Bremo Rd
Ste 105
Richmond, VA 23226
Phone (804) 287-7501

5875 Bremo Rd
Ste G11
Richmond, VA 23226
Phone (804) 287-7804

6605 W Broad St
Ste B
Richmond, VA 23230
Phone (804) 281-0215

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, Cincinnati, 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, Blue Ash, 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 Richmond MKT Sep 8, 2020
Corporate DirectorBoard Member Sep 8, 2020
W-2 Managing EmployeeCfo Richmond MKT Sep 8, 2020
Mary Shimo Individual Corporate DirectorBoard Member Jan 1, 2023
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 Sep 9, 1996 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

Practitioners 159

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 159

Affiliated clinicians 1,443

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

View all 1,443

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": "1600732800000",
    "number": "1962464016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 639994",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452639994",
            "fax_number": "866-449-0896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5801 BREMO RD",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232261907",
            "telephone_number": "804-285-2011",
            "fax_number": "804-285-8327"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BON SECOURS ST. MARY'S HOSPITAL OF RICHMOND LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-04",
        "last_updated": "2020-09-22",
        "certification_date": "2020-09-22",
        "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": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "VA",
            "license": "H1723",
            "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": "4900596",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bon Secours St Mary's Hospital",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Bon Secours St Mary's Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Richmond, VA

Sources for this page

Verify at the official NPI Registry.