Select Specialty Hospital - San Antonio Inc

Primary specialty

Long Term Care HospitalTaxonomy code 282E00000X

License

007193 Issued in TX

Legal business name

SELECT SPECIALTY HOSPITAL - SAN ANTONIO INC

Practice address

111 Dallas St
4TH FL
San Antonio, TX 78205-1201

Phone

(210) 297-7188

Fax

(210) 297-0949

NPI assigned

Jul 26, 2005

Last updated

Jul 8, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Michael E. Tarvin

Title

Vice President

Phone

(717) 972-1100

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1063412666. Details of each certification follow.

• CCN 450837 Hospital · Terminated · Name & address match · Details

Hospital certification: CCN 450837

Legal name

SELECT SPECIALTY HOSPITAL SAN ANTONIO

Certification status

Terminated Voluntary: merger or closure, May 1, 2001

Provider type (POS)

Hospital – Short-term

Participating since

Sep 27, 2000

Last certification

Sep 21, 2000

Beds

34

Ownership / control type

Private (for profit)

Facility address

111 Dallas Street 4TH Floor
San Antonio, TX 78205

Tax ID family

KND Development 68 LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• KND Development 68, LLC

  dba Kindred Hospital - San Antonio Central

  • Long Term Care Hospital
  • San Antonio, TX
  • NPI 1558721365
  NPD tax ID

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

{
    "created_epoch": "1122336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1467936000000",
    "number": "1063412666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4714 GETTYSBURG RD",
            "address_2": "LEGAL DEPT.",
            "city": "MECHANICSBURG",
            "state": "PA",
            "postal_code": "170554325",
            "telephone_number": "717-972-1100",
            "fax_number": "717-975-9981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 DALLAS ST",
            "address_2": "4TH FL",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782051201",
            "telephone_number": "210-297-7188",
            "fax_number": "210-297-0949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SELECT SPECIALTY HOSPITAL - SAN ANTONIO INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-26",
        "last_updated": "2016-07-08",
        "status": "A",
        "authorized_official_last_name": "TARVIN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "717-972-1100",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "282E00000X",
            "taxonomy_group": "",
            "desc": "Long Term Care Hospital",
            "state": "TX",
            "license": "007193",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS TX",
            "identifier": "HH0992",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Select Physical Therapy Texas Limited Partnership (Select Physical Therapy)
• Select Physical Therapy Texas Limited Partnership
• Select Physical Therapy Texas Limited Partnership (Select Physical Therapy)
• Select Physical Therapy Texas Limited Partnership (Select Physical Therapy)
• Select Primary Care LLC
• Bo Lee Self-Gilbert
• Ashleigh Self, RN
• Debra Self, SLP
• Steven Michael Self, P.A.
• Selfjourney Counseling PLLC

• Long Term Care Hospital in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Long Term Care Hospital in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.