BON SECOURS MARYVIEW NURSING CARE CENTER LLC
NPI 1124033980
Skilled Nursing Facility in Suffolk, VA

NPI Status: Active since July 30, 2006

Contact Information

4775 BRIDGE RD
SUFFOLK, VA
ZIP 23435
Phone: (757) 686-0488
Fax: (757) 686-8211

Get Directions Reviews

  • Organization
  • Skilled Nursing Facility
  • CLIA Number: 49D0719991
  • CLIA Cert. Type: Skilled Nursing Facility/Nursing Facility
  • CLIA Exp. Date: 08-31-2026

About BON SECOURS MARYVIEW NURSING CARE CENTER LLC

This page provides the complete NPI Profile along with additional information for Bon Secours Maryview Nursing Care Center Llc, a provider established in Suffolk, Virginia operating as a Skilled Nursing Facility. The healthcare provider is registered in the NPI registry with number 1124033980 assigned on July 2006. The practitioner's primary taxonomy code is 314000000X with license number NH2511 (VA). The provider is registered as an organization and their NPI record was last updated 5 years ago. The authorized official of this NPI record is Kimberly Ralston (System Director)

NPI
1124033980
Provider Name
BON SECOURS MARYVIEW NURSING CARE CENTER LLC
Entity Type
Organization
Location Address
4775 BRIDGE RD SUFFOLK, VA 23435
Location Phone
(757) 686-0488
Location Fax
(757) 686-8211
Mailing Address
8580 MAGELLAN PKWY RICHMOND, VA 23227
Mailing Phone
(804) 627-5573
Mailing Fax
(757) 686-8211
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
07-30-2006
Last Update Date
10-22-2020
Code Navigator

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Skilled Nursing Facility

Taxonomy Code
314000000X
Type
Nursing & Custodial Care Facilities
License No.
NH2511
License State
VA
Taxonomy Description
(1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1313M00000XNursing & Custodial Care Facilities

Nursing Facility/Intermediate Care Facility

NH2511 (VA)

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

KIMBERLY RALSTON

Authorized Official Title
SYSTEM DIRECTOR
Authorized Official Phone
(419) 996-5119

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
4952065MEDICAID (05)VA 

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
49D0719991
Facility Type
Skilled Nursing Facility/Nursing Facility
Certificate Effective Date
September 01, 2024
Certificate Expiration Date
August 31, 2026
Laboratory Director
NABIL TADROS
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Bon Secours Maryview Nursing Care Center Llc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

Reviews for BON SECOURS MARYVIEW NURSING CARE CENTER LLC

There are currently no reviews for this provider. Be the first person to share your experience with this provider by filling out our review form. Your insights are appreciated and will help others make informed decisions.

NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1124033980
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2144036916
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 1 + 4 + 4 + 0 + 3 + 6 + 9 + 1 + 6 + 24 = 60
Step 3: because the number obtained in step 2 ends in zero, the check digit is zero.
0

The NPI number 1124033980 is valid because the calculated check digit 0 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 3 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1720261381BON SECOURS MARYVIEW NURSING CARE CENTER
Organization
Nursing Facility/Intermediate Care Facility4775 BRIDGE RD
SUFFOLK, VA 23435
(757) 686-0488
1386210326SUFFOLK VA OPCO LLC
Organization
Skilled Nursing Facility4775 BRIDGE RD
SUFFOLK, VA 23435
(757) 686-0488
1548028285NORTHERN CARDINAL REHABILITATION AND NURSING LLC
Organization
Skilled Nursing Facility4775 BRIDGE RD
SUFFOLK, VA 23435
(757) 686-0488

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1124033980, enumerated in the NPI registry as an "organization" on July 30, 2006

The provider is located at 4775 Bridge Rd Suffolk, Va 23435 and the phone number is (757) 686-0488

This medical organization specializes in Skilled Nursing Facility with taxonomy code 314000000X

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.

The provider's CLIA number is 49D0719991 for a "skilled nursing facility/nursing facility" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria..

This NPI record was last updated on July 30, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.