Select Specialty Hospital - Panama City Inc
Organization Active NPI Long Term Care Hospital · Panama City, FL
NPI 1194725713 · NPPES record last updated Sep 10, 2025
Key facts
- NPI
- 1194725713
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Long Term Care Hospital 282E00000X
- License
- 4475 (FL)
- Legal business name
- SELECT SPECIALTY HOSPITAL - PANAMA CITY INC
- Practice address
- 615 N Bonita Ave
Panama City, FL 32401-3623 - Phone
- (850) 767-3199
- Fax
- (850) 767-3181
- NPI assigned
- Jul 26, 2005
- Organization subpart
- No
Authorized official
- Name
- Mr. John Duggan
- Title
- Vice President
- Phone
- (717) 972-1100
Facilities with the same owner 129
Affiliated clinicians 5
-
Alhakam Hudaihed, MD
-
Ashraf Misal Khan, M.D.
-
Jesus Maria Ramirez, M.D.
-
Ahmad Oussama Rifai, M.D.
-
Larry T Wong, D.O.
Medicare Care Compare: Long-term care hospital
- Listed as
- Select Specialty Hospital - Panama City
- Ownership
- For profit
- Certified
- Aug 1, 2004
- Medicare certification status
- Active
- Beds
- 30
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 10D1026565 | Select Specialty Hospital Panama City Inc | Certificate of waiver | Jun 8, 2028 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
Hospital certification: CCN 102017
- Legal name
- SELECT SPECIALTY HOSPITAL - PANAMA CITY INC
- Doing business as
- SELECT SPECIALTY HOSPITAL PANAMA CITY
- Certification status
- Active
- Provider type (POS)
- Hospital – Long-term
- Participating since
- Aug 1, 2004
- Last certification
- Sep 24, 2020
- Beds
- 30
- Ownership / control type
- Private (for profit)
- Organization structure
- Corporation · Proprietary
- Incorporated
- Feb 6, 2002 in DE
- Enrollment address
- 615N Bonita Ave
Panama City, FL 32401-3623 - Hospital subgroups
- Long-term
All disclosed owners & managing parties 9
| Name | Role | Since | Share |
|---|---|---|---|
| Select Medical Corporation |
5% Or Greater Indirect Ownership Interest | Jan 1, 2005 | 100% |
| Operational/Managerial Control | Jan 1, 2005 | 100% | |
| Thomas Mullin |
Corporate Officer | Sep 3, 2025 | |
| John Saich |
Corporate Officer | Sep 3, 2025 | |
| Matthew Presley |
Corporate Officer |
Aug 1, 2022 | |
| W-2 Managing Employee |
Aug 1, 2022 | ||
| Operational/Managerial Control |
Aug 1, 2022 | ||
| Robert Breighner |
W-2 Managing Employee |
Sep 3, 2025 | |
| Sempercare, Inc. |
5% Or Greater Direct Ownership Interest | Jan 1, 2005 | 100% |
| Michael Malatesta |
Corporate Officer | Sep 3, 2025 | |
| Robert Kido |
Corporate Officer | Sep 3, 2025 | |
| John Duggan |
Corporate Officer | Jan 1, 2005 | |
| Corporate Director | Sep 3, 2025 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031023000034 | FL | Part a Provider - Hospital | 2365354032 | Practice locations: Panama City, FL |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Long Term Care Hospital | 282E00000X | 4475 | FL | Yes |
Addresses
Primary practice location
615 N Bonita Ave
Panama City, FL 32401-3623
Mailing address
4714 Gettysburg Rd
Legal Dept.
Mechanicsburg, PA 17055-4325
Phone (717) 972-1100
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0103438-00 | Medicaid | FL | |
| 141 | Other | FL | BLUE CROSS FL |
NPI Registry JSON
{
"created_epoch": "1122336000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1757462400000",
"number": "1194725713",
"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": "615 N BONITA AVE",
"city": "PANAMA CITY",
"state": "FL",
"postal_code": "324013623",
"telephone_number": "850-767-3199",
"fax_number": "850-767-3181"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SELECT SPECIALTY HOSPITAL - PANAMA CITY 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": "717-972-1100",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "282E00000X",
"taxonomy_group": "",
"desc": "Long Term Care Hospital",
"state": "FL",
"license": "4475",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0103438-00",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS FL",
"identifier": "141",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 10, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.