NPIMap

Organization Active NPI

Select Specialty Hospital - Conroe Inc

  • Long Term Care Hospital
  • Conroe, TX
National Provider Identifier
1154320323
Registry record updated Mar 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care HospitalTaxonomy code 282E00000X
License
007947 Issued in TX
Legal business name
SELECT SPECIALTY HOSPITAL - CONROE INC
Practice address
506 Medical Center Blvd
2ND Floor
Conroe, TX 77304-2826
Phone
(936) 538-3158
Fax
(936) 538-3156
NPI assigned
Jul 19, 2005
Last updated
Mar 11, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2008

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) 972-1139

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Long Term Care Hospital 282E00000X 007947 TX Primary

Addresses

Primary practice location

506 Medical Center Blvd
2ND Floor
Conroe, TX 77304-2826

Mailing address

4716 Old Gettysburg Rd
Legal Dept.
Mechanicsburg, PA 17055-4325
Phone (717) 972-1139

Other identifiers 1

IdentifierTypeStateIssuer
HH1043OtherTXBCBS TX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI to CCN mapping 2

The Medicare certification numbers (CCNs) connected to NPI 1154320323. Details of each certification follow.

Hospital certification: CCN 450870

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
SELECT SPECIALTY HOSPITAL - CONROE, INC (452089)
Certification status
Terminated Other: provider status change, Dec 14, 2004
Provider type (POS)
Hospital – Short-term
Participating since
Aug 20, 2003
Last certification
Jul 25, 2003
Beds
46
Ownership / control type
Private (for profit)
Facility address
506 Medical Center Boulevard
Conroe, TX 77304

Hospital certification: CCN 452089

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
SELECT SPECIALTY HOSPITAL CONROE
Certification status
Terminated Voluntary: merger or closure, Jul 31, 2008
Provider type (POS)
Hospital – Long-term
Participating since
Mar 1, 2004
Last certification
Mar 1, 2004
Beds
46
Ownership / control type
Private (for profit)
Facility address
506 Medical Center Boulevard
Conroe, TX 77304

National Provider Directory

National Provider Directory

Member of 1

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

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1121731200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205193600000",
    "number": "1154320323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4716 OLD GETTYSBURG RD",
            "address_2": "LEGAL DEPT.",
            "city": "MECHANICSBURG",
            "state": "PA",
            "postal_code": "170554325",
            "telephone_number": "717-972-1139",
            "fax_number": "717-975-9981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "506 MEDICAL CENTER BLVD",
            "address_2": "2ND FLOOR",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773042826",
            "telephone_number": "936-538-3158",
            "fax_number": "936-538-3156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SELECT SPECIALTY HOSPITAL - CONROE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-19",
        "last_updated": "2008-03-11",
        "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": "717-972-1139",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "282E00000X",
            "taxonomy_group": "",
            "desc": "Long Term Care Hospital",
            "state": "TX",
            "license": "007947",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS TX",
            "identifier": "HH1043",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Conroe, TX

Sources for this page

Verify at the official NPI Registry.