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Pam II of Covington, LLC

Organization Active NPI Long Term Care Hospital · Covington, LA

NPI 1417930751 · NPPES record last updated Feb 7, 2023

Key facts

NPI
1417930751
Entity type
Organization (NPI type 2)
Primary specialty
Long Term Care Hospital 282E00000X
License
680 (LA)
Legal business name
PAM II OF COVINGTON, LLC
Practice address
20050 Crestwood Blvd
Covington, LA 70433-5207
Phone
(985) 902-8148
NPI assigned
Nov 21, 2005
Organization subpart
No

Authorized official

Name
Mr. Karick Stober
Title
Chief Financial Officer
Phone
(717) 731-9660

Corporate family (same tax ID) 1

Organizations that report the same tax identification number in the National Provider Directory.

Member of 3

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

Facilities with the same owner 42

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

View all 42

Practitioners 3

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

Affiliated clinicians 13

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

Medicare Care Compare: Inpatient rehabilitation facility

Listed as
P a M Specialty Hospital of Covington CCN 19TA48
Ownership
For profit
Certified
Jan 1, 2021

Source: Medicare Care Compare.

Medicare Care Compare: Long-term care hospital

Listed as
P a M Specialty Hospital of Covington CCN 192048
Ownership
For profit
Certified
Jan 30, 2004
Medicare certification status
Active (Provider of Services file)
Beds
58

Source: Medicare Care Compare.

Laboratory certificates & supplier records

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
19D0927145Pam Specialty Hospital of Covington
20050 Crestwood Boulevard, Covington, LA 70433		AccreditationSep 17, 2026

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in LA

Hospital certification: CCN 192048

Legal name
PAM II OF COVINGTON, LLC
Doing business as
PAM SPECIALTY HOSPITAL OF COVINGTON
Certification status
Active
Provider type (POS)
Hospital – Long-term
Participating since
Jan 30, 2004
Last certification
Jan 17, 2026
Beds
58 (30 certified)
Ownership / control type
Private (for profit)
Most recent change of ownership
Mar 17, 2010 (2 total)
Organization structure
LLC · Proprietary
Incorporated
Apr 14, 2009 in DE
Enrollment address
20050 Crestwood Boulevard
Covington, LA 70433-5207
Other Hospital Practice Location
Hospital subgroups
Long-term

Hospital certification: CCN 19TA48

Legal name
PAM II OF COVINGTON, LLC
Organization structure
LLC · Proprietary
Enrollment address
20050 Crestwood Blvd
Rooms 301-308 & 401-408
Covington, LA 70433-5207
Hospital Rehabilitation Unit
Hospital subgroups
Rehabilitation unit

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
Karick E Stober
Individual 		Corporate Officer
Vice President/Treasurer		 Sep 1, 2012
Anthony F Misitano
Individual 		Corporate Officer
President		 Apr 20, 2016
Pam Cubed LLC
Organization · Enola, PA
LLC, For-profit, Chain home office 		5% Or Greater Indirect Ownership Interest Mar 1, 2021 92.65%
Other Apr 1, 2024
5% Or Greater Indirect Ownership Interest Mar 1, 2021 87.77%
Pam II Holdings, LLC
Organization · Enola, PA
Created for acquisition, LLC, For-profit 		5% Or Greater Direct Ownership Interest May 23, 2016 18%
5% Or Greater Indirect Ownership Interest Mar 1, 2021 74.65%
5% Or Greater Indirect Ownership Interest Mar 20, 2010 74.65%
Wells Fargo Bank, N.a.
Organization · Minneapolis, MN 		5% Or Greater Security Interest Jul 23, 2024
5% Or Greater Security Interest Jul 23, 2024 100%
Covington Hospital General Manager, LLC
Organization · Enola, PA
LLC 		5% Or Greater Direct Ownership Interest Mar 17, 2010 82%
Timothy Scott Thigpen
Individual 		W-2 Managing Employee May 11, 2026
Brittany Misitano
Individual 		5% Or Greater Indirect Ownership Interest Mar 1, 2021 73.6%
Corporate Officer Apr 2, 2026
5% Or Greater Indirect Ownership Interest Mar 1, 2021 69.58%
Pam II Management Company, LLC
Organization · Enola, PA
LLC 		Operational/Managerial Control Mar 17, 2010
Pam Cubed Specialty Hospitals LLC
Organization · Enola, PA
LLC, Holding company, For-profit 		5% Or Greater Indirect Ownership Interest Mar 1, 2021 92.65%
5% Or Greater Indirect Ownership Interest Mar 1, 2021 87.77%

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20100512000264 LA Part a Provider - Hospital 0143358184 Practice locations: Covington, LA
O20210107000566 LA Part a Provider - Hospital 0143358184 Practice locations: Covington, LA

National Provider Directory

Tax ID family
Pam II of Covington LLC (2 organizations share this tax ID)

Locations

20050 Crestwood Blvd
Rm 301308
Covington, LA 70433
Phone (985) 875-7525

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Hospital Unit 273Y00000X
Long Term Care Hospital 282E00000X 680 LA Yes
Rehabilitation Hospital 283X00000X

Addresses

Primary practice location

20050 Crestwood Blvd
Covington, LA 70433-5207

Mailing address

1828 Good Hope Rd
Suite 102
Enola, PA 17025-1233
Phone (717) 731-9660

Other identifiers

IdentifierTypeStateIssuer
60739OtherLABLUE CROSS OF LA
1703176MedicaidLA
09326820MedicaidMS

Other names

  • PAM Health Specialty and Rehabilitation Hospital of Covington Doing business as
  • PAM Specialty Hospital of Covington Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Feb 7, 2023.

{
    "created_epoch": "1132531200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675728000000",
    "number": "1417930751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1828 GOOD HOPE RD",
            "address_2": "SUITE 102",
            "city": "ENOLA",
            "state": "PA",
            "postal_code": "170251233",
            "telephone_number": "717-731-9660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20050 CRESTWOOD BLVD",
            "city": "COVINGTON",
            "state": "LA",
            "postal_code": "704335207",
            "telephone_number": "985-902-8148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAM II OF COVINGTON, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-21",
        "last_updated": "2023-02-07",
        "certification_date": "2023-02-07",
        "status": "A",
        "authorized_official_last_name": "STOBER",
        "authorized_official_first_name": "KARICK",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "717-731-9660",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "273Y00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Unit",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "282E00000X",
            "taxonomy_group": "",
            "desc": "Long Term Care Hospital",
            "state": "LA",
            "license": "680",
            "primary": true
        },
        {
            "code": "283X00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Hospital",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF LA",
            "identifier": "60739",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1703176",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09326820",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PAM Health Specialty and Rehabilitation Hospital of Covington",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PAM Health Specialty and Rehabilitation Hospital of Covington",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PAM Specialty Hospital of Covington",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Covington, LA

All providers in Covington, LA · Long Term Care Hospital in Louisiana

Sources for this page

Verify at the official NPI Registry.