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Organization Active NPI

Bon Secours St. Mary'S Hospital of Richmond LLC

  • 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
Practice address
5801 Bremo Rd
Richmond, VA 23226-1907
Phone
(804) 285-2011
Fax
(804) 285-8327
NPI assigned
Apr 4, 2006
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Kimberly 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 on the same Medicare enrollment 53

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

View all 53

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) 20

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 159

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

View all 159

Affiliated clinicians 1,443

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

View all 1,443

Care Compare: Hospital

Medicare Care Compare
Listed as
Bon Secours St Marys HospitalCCN 490059
Overall star rating
5 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
Active (Provider of Services file)
Emergency services
Yes

Medicare participation

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

Hospital certification: CCN 490059

Medicare enrollment files
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

All disclosed owners & managing parties 20

Medicare enrollment files

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

Medicare enrollment records 2

Medicare enrollment files
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

National Provider Directory

National Provider Directory
Tax ID family
Bon Secours St Marys Hospital of Richmond LLC (21 organizations share this tax ID)

Locations

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

10150 Staples Mill Rd
Glen Allen, VA 23060

13700 St Francis Blvd
Ste 606
Midlothian, VA 23114
Phone (804) 423-8462

1850 Pocahontas Trl
Fl 2
Quinton, VA 23141

5855 Bremo Rd
Ste 403B
Richmond, VA 23226

7229 Forest Ave
Ste 110
Richmond, VA 23226

1900 Lauderdale Dr
Richmond, VA 23238
Phone (804) 729-5563

5875 Bremo Rd
Ste 311
Richmond, VA 23226
Phone (804) 287-3550

7001 Forest Ave
Richmond, VA 23230
Phone (804) 282-7857

1510 N 28th St
Ste 210
Richmond, VA 23223
Phone (804) 371-1689

Specialties & licenses 2

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

Addresses

NPPES NPI Registry

Primary practice location

5801 Bremo Rd
Richmond, VA 23226-1907

Mailing address

PO Box 639994
Cincinnati, OH 45263-9994

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
4900596MedicaidVA

Other names 1

NPPES NPI Registry
  • Bon Secours St Mary's Hospital Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 22, 2020.

{
    "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.