NPIMap

Organization Active NPI

Ltach at Riverside, LLC

Doing business as Hampton Roads Specialty Hospital

  • Long Term Care Hospital
  • Newport News, VA
National Provider Identifier
1073571865
Registry record updated Sep 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care HospitalTaxonomy code 282E00000X
License
H1925 Issued in VA
Legal business name
LTACH AT RIVERSIDE, LLC
Doing business as
Hampton Roads Specialty Hospital
Practice address
500 J Clyde Morris Blvd
4TH Floor East and 4TH Floor Annex
Newport News, VA 23601-1929
Phone
(757) 928-8261
Fax
(757) 928-8271
NPI assigned
May 2, 2006
Last updated
Sep 10, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2025

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

Authorized official

Name
Mr. John Duggan Jr.
Title
VP
Phone
(717) 972-1100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Long Term Care Hospital 282E00000X H1925 VA Primary

Addresses

Primary practice location

500 J Clyde Morris Blvd
4TH Floor East and 4TH Floor Annex
Newport News, VA 23601-1929

Mailing address

4714 Gettysburg Rd
Legal Dept
Mechanicsburg, PA 17055-4325
Phone (717) 975-4503

Other identifiers 1

IdentifierTypeStateIssuer
010246148MedicaidVA

Other names 1

  • Hampton Roads Specialty Hospital Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050317000902 VA Part A Provider - Hospital 4789639121 Practice locations: Newport News, VA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1073571865. Details of each certification follow.

Hospital certification: CCN 492008

Legal name
LTACH AT RIVERSIDE, LLC
Doing business as
SELECT SPECIALTY HOSPITAL - HAMPTON ROADS
Certification status
Active
Provider type (POS)
Hospital – Long-term
Participating since
May 1, 2006
Last certification
Jun 5, 2012
Beds
25
Ownership / control type
Private (not for profit)
Organization structure
LLCProprietary
Enrollment address
500 J. Cylde Morris Blvd.
4 FL E and 4 FL Annex
Newport News, VA 23601-1929
Main/Primary Hospital Location
Hospital subgroups
Acute care, Long-term

Care Compare: Long-term care hospital

Medicare Care Compare
Listed as
Select Specialty Hospital - Hampton RoadsCCN 492008 · All quality measures
Ownership
Non-profit
Certified
May 1, 2006
Medicare certification status
ActiveFrom the Provider of Services file
Beds
25

National Provider Directory

National Provider Directory
Tax ID family
Ltach at Riverside 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.

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

4732 Gettysburg Rd
Mechanicsburg, PA 17055

245 Chesapeake Ave
Fl 4
Newport News, VA 23607
Phone (757) 534-5000

Ownership & related parties

All disclosed owners & managing parties 11

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Hospital Holdings Corporation Organization, Mechanicsburg, PA Corporation, For-profit 5% Or Greater Direct Ownership Interest Jun 1, 2017 51%
Select Medical Corporation Organization, Mechanicsburg, PA Corporation, For-profit 5% Or Greater Indirect Ownership Interest Jun 1, 2017 100%
Thomas Mullin Individual Corporate Officer Sep 4, 2025
Rehabilitation Institute of Virginia Inc Organization, Newport News, VA Non-profit 5% Or Greater Direct Ownership Interest Jun 1, 2017 49%
John Saich Individual Corporate Officer Sep 4, 2025
Daniel Ballin Individual Corporate OfficerCeo Jan 1, 2025
W-2 Managing EmployeeAd; Jan 1, 2025
Operational/Managerial ControlCeo Jan 1, 2025
Robert Breighner Individual W-2 Managing EmployeeCompliance Officer Sep 4, 2025
Select Specialty Hospitals Inc Organization, Mechanicsburg, PA Corporation, For-profit 5% Or Greater Indirect Ownership Interest Jun 1, 2017 51%
Michael Malatesta Individual Corporate Officer Sep 4, 2025
Robert Kido Individual Corporate Officer Sep 4, 2025
John Duggan Individual Corporate Officer Sep 1, 2025
Corporate Director Sep 1, 2025

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 129

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 129

Practitioners & affiliated clinicians

Affiliated clinicians 5

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

NPI Registry JSON

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

{
    "created_epoch": "1146528000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757462400000",
    "number": "1073571865",
    "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": "717-975-4503",
            "fax_number": "717-975-9981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 J CLYDE MORRIS BLVD",
            "address_2": "4TH FLOOR EAST AND 4TH FLOOR ANNEX",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236011929",
            "telephone_number": "757-928-8261",
            "fax_number": "757-928-8271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LTACH AT RIVERSIDE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-02",
        "last_updated": "2025-09-10",
        "certification_date": "2025-09-10",
        "status": "A",
        "authorized_official_last_name": "DUGGAN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "717-972-1100",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "282E00000X",
            "taxonomy_group": "",
            "desc": "Long Term Care Hospital",
            "state": "VA",
            "license": "H1925",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010246148",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hampton Roads Specialty Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Newport News, VA

Sources for this page

Verify at the official NPI Registry.