NPIMap

Organization Active NPI

Bon Secours-St. Mary'S Hospital of Richmond, Inc.

  • Sleep Disorder Diagnostic Clinic/Center
  • Richmond, VA
National Provider Identifier
1992031348
Registry record updated Oct 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sleep Disorder Diagnostic Clinic/CenterTaxonomy code 261QS1200X
License
H1833 Issued in VA
Legal business name
BON SECOURS-ST. MARY'S HOSPITAL OF RICHMOND, INC.
Practice address
5500 Monument Ave
Suite K
Richmond, VA 23226-1452
Phone
(804) 673-8160
Fax
(804) 673-8165
NPI assigned
Oct 20, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2018

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

Authorized official

Name
George Odell Butler
Title
Director of Corp Responsibility
Phone
(804) 281-0271

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sleep Disorder Diagnostic Clinic/Center 261QS1200X H1833 VA Primary

Addresses

Primary practice location

5500 Monument Ave
Suite K
Richmond, VA 23226-1452

Mailing address

5801 Bremo Rd
Richmond, VA 23226-1907
Phone (804) 285-2011

Other identifiers 1

IdentifierTypeStateIssuer
4900596MedicaidVA

Other names 1

  • Bon Secours St. Mary's Hospital Sleep Lab Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091002000331 VA Part A Provider - Hospital 8527969476 5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment

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 on the same Medicare enrollment 5

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

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
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

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.

Practitioners & affiliated clinicians

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": "1255996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1540339200000",
    "number": "1992031348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5500 MONUMENT AVE",
            "address_2": "SUITE K",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232261452",
            "telephone_number": "804-673-8160",
            "fax_number": "804-673-8165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BON SECOURS-ST. MARY'S HOSPITAL OF RICHMOND, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-20",
        "last_updated": "2018-10-24",
        "status": "A",
        "authorized_official_last_name": "BUTLER",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "ODELL",
        "authorized_official_title_or_position": "DIRECTOR OF CORP RESPONSIBILITY",
        "authorized_official_telephone_number": "804-281-0271"
    },
    "taxonomies": [
        {
            "code": "261QS1200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Sleep Disorder Diagnostic",
            "state": "VA",
            "license": "H1833",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4900596",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bon Secours St. Mary's Hospital Sleep Lab",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Bon Secours St. Mary's Hospital Sleep Lab",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Richmond, VA

Sources for this page

Verify at the official NPI Registry.