NPIMap

Organization Active NPI

Select Specialty Hospital - Northeast Ohio Inc

  • Long Term Care Hospital
  • Canton, OH
National Provider Identifier
1174523666
Registry record updated Sep 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care HospitalTaxonomy code 282E00000X
License
1421 Issued in OH
Legal business name
SELECT SPECIALTY HOSPITAL - NORTHEAST OHIO INC
Practice address
1320 Mercy Dr NW
6TH Floor
Canton, OH 44708-2614
Phone
(330) 344-1030
Fax
(330) 344-6035
NPI assigned
Jul 26, 2005
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
Title
Vice President
Phone
(717) 972-1139

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Long Term Care Hospital 282E00000X 1421 OH Primary

Addresses

Primary practice location

1320 Mercy Dr NW
6TH Floor
Canton, OH 44708-2614

Mailing address

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

Other identifiers 3

IdentifierTypeStateIssuer
000000157636OtherOHBCBS OH
123635400OtherOHBLACK LUNG
2012968MedicaidOH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031021000008 OH Part A Provider - Hospital 0648182469 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Canton, OH

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1174523666. Details of each certification follow.

Hospital certification: CCN 362016

Legal name
SELECT SPECIALTY HOSPITAL - NORTHEAST OHIO INC
Doing business as
SELECT SPECIALTY HOSPITAL NORTHEAST OHIO (CANTON CAMPUS)
Certification status
Active
Provider type (POS)
Hospital – Long-term
Participating since
Mar 1, 1997
Last certification
Jul 28, 2016
Beds
61
Ownership / control type
Private (for profit)
Organization structure
CorporationProprietary
Incorporated
Feb 13, 1996 in MO
Enrollment address
2600 6TH St SW
FL 4
Canton, OH 44710-1702
Main/Primary Hospital Location
Hospital subgroups
Acute care, Long-term

Other NPIs on the same Medicare enrollment 1

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

Care Compare: Long-term care hospital

Medicare Care Compare
Listed as
Select Specialty Hospital-Northeast Ohio, IncCCN 362016 · All quality measures
Ownership
For profit
Certified
Mar 1, 1997
Medicare certification status
ActiveFrom the Provider of Services file
Beds
61

National Provider Directory

National Provider Directory

Member of 1

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

Ownership & related parties

All disclosed owners & managing parties 10

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

NameRoleSinceShare
Select Specialty Hospital - Northeast Ohio Inc Organization, Mechanicsburg, PA For-profit 5% Or Greater Direct Ownership Interest Oct 1, 2003 100%
Select Medical Corporation Organization, Mechanicsburg, PA For-profit 5% Or Greater Indirect Ownership Interest Dec 10, 1996 100%
Operational/Managerial Control Dec 10, 1996 100%
Thomas Mullin Individual Corporate Officer Sep 5, 2025
Intensiva Healthcare Corporation Organization, Mechanicsburg, PA For-profit 5% Or Greater Direct Ownership Interest Dec 16, 1998 100%
John Saich Individual Corporate Officer Sep 5, 2025
Deborah Hauritz Individual Corporate OfficerCeo Dec 11, 2023
W-2 Managing EmployeeCeo Dec 11, 2023
Operational/Managerial ControlCeo Dec 11, 2023
Robert Breighner Individual W-2 Managing EmployeeCompilance Officer Sep 5, 2025
Michael Malatesta Individual Corporate Officer Sep 5, 2025
Robert Kido Individual Corporate Officer Sep 5, 2025
John Duggan Individual Corporate Officer Oct 21, 2003
Corporate Director Sep 5, 2025

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 8

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": "1122336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757462400000",
    "number": "1174523666",
    "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": "1320 MERCY DR NW",
            "address_2": "6TH FLOOR",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447082614",
            "telephone_number": "330-344-1030",
            "fax_number": "330-344-6035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SELECT SPECIALTY HOSPITAL - NORTHEAST OHIO INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-26",
        "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": "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": "OH",
            "license": "1421",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OH",
            "identifier": "000000157636",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLACK LUNG",
            "identifier": "123635400",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2012968",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, OH

Sources for this page

Verify at the official NPI Registry.