NPIMap

Organization Active NPI

Select Specialty Hospital - Jackson Inc

  • Long Term Care Hospital
  • Jackson, MS
National Provider Identifier
1255330163
Registry record updated Sep 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care HospitalTaxonomy code 282E00000X
License
22331 Issued in MS
Legal business name
SELECT SPECIALTY HOSPITAL - JACKSON INC
Practice address
5903 Ridgewood Rd
Jackson, MS 39211-3700
Phone
(601) 376-1099
Fax
(601) 376-1013
NPI assigned
Jul 21, 2005
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) 972-1100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Long Term Care Hospital 282E00000X 22331 MS Primary

Addresses

Primary practice location

5903 Ridgewood Rd
Jackson, MS 39211-3700

Mailing address

4714 Gettysburg Rd
Legal Dept.
Mechanicsburg, PA 17055-4325
Phone (717) 972-1100

Other identifiers 1

IdentifierTypeStateIssuer
20467OtherMSBCBS MS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050907000718 MS Part A Provider - Hospital 3072545318 Practice locations: Jackson, MS

Hospital certification: CCN 252007

Legal name
SELECT SPECIALTY HOSPITAL - JACKSON INC
Doing business as
SELECT SPECIALTY HOSPITAL - JACKSON
Certification status
Active
Provider type (POS)
Hospital – Long-term
Participating since
Mar 1, 2003
Last certification
Oct 6, 2006
Beds
53
Ownership / control type
Private (not for profit)
Organization structure
CorporationProprietary
Incorporated
Jan 13, 2001 in DE
Enrollment address
5903 Ridgewood Rd
Jackson, MS 39211-3700
Main/Primary Hospital Location
Hospital subgroups
Long-term

Care Compare: Long-term care hospital

Medicare Care Compare
Listed as
Select Specialty Hospital JacksonCCN 252007 · All quality measures
Ownership
Non-profit
Certified
Mar 1, 2003
Medicare certification status
ActiveFrom the Provider of Services file
Beds
53

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
25D1000486Select Specialty Hospital Jackson Inc5903 Ridgewood Rd, Jackson, MS 39211AccreditationMar 30, 2028

National Provider Directory

National Provider Directory

Member of 1

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

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

5903 Ridgewood Rd
Ste 100
Jackson, MS 39211
Phone (601) 481-5214

1850 Chadwick Dr
Fl 5
Jackson, MS 39204
Phone (601) 376-1005

Ownership & related parties

All disclosed owners & managing parties 9

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

NameRoleSinceShare
Select Medical Corporation Organization, Mechanicsburg, PA For-profit 5% Or Greater Indirect Ownership Interest Jul 29, 2002 100%
Operational/Managerial Control Jul 29, 2002 100%
Thomas Mullin Individual Corporate Officer Aug 29, 2025
John Saich Individual Corporate Officer Aug 29, 2025
Robert Shannon Canard Individual Corporate OfficerCeo Dec 2, 2019
W-2 Managing EmployeeCeo Dec 2, 2019
Operational/Managerial ControlCeo Dec 2, 2019
Robert Breighner Individual W-2 Managing EmployeeCompliance Officer Aug 29, 2025
Select Specialty Hospitals Inc Organization, Mechanicsburg, PA For-profit 5% Or Greater Direct Ownership Interest Jul 29, 2002 100%
Michael Malatesta Individual Corporate Officer Apr 8, 2025
Robert Kido Individual Corporate Officer Aug 29, 2025
John Duggan Individual Corporate Officer Jul 29, 2002
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.

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Select Specialty Hospital-BelhavenJackson, MS, CCN 252003 Hospital 5% Or Greater Direct Ownership Interest (100%) Aug 2, 2016

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

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": "1121904000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757462400000",
    "number": "1255330163",
    "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": "5903 RIDGEWOOD RD",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392113700",
            "telephone_number": "601-376-1099",
            "fax_number": "601-376-1013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SELECT SPECIALTY HOSPITAL - JACKSON INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-21",
        "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": "MS",
            "license": "22331",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS MS",
            "identifier": "20467",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

Verify at the official NPI Registry.