NPIMap

Organization Active NPI

Pam Rehabilitation Hospital of Greeley LLC

  • Rehabilitation Hospital
  • Greeley, CO
National Provider Identifier
1558059428
Registry record updated May 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation HospitalTaxonomy code 283X00000X
Legal business name
PAM REHABILITATION HOSPITAL OF GREELEY LLC
Practice address
6810 W 10TH St
Greeley, CO 80634
Phone
(717) 731-9660
NPI assigned
Apr 27, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 19, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Anthony Misitano
Title
President
Phone
(717) 731-9660

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Hospital 283X00000X Primary

Addresses

Primary practice location

6810 W 10TH St
Greeley, CO 80634

Mailing address

1828 Good Hope Rd Ste 102
Enola, PA 17025-1203
Phone (717) 731-9660

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231208001258 CO Part A Provider - Hospital 2961851423 Practice locations: Greeley, CO

Hospital certification: CCN 063039

Legal name
PAM REHABILITATION HOSPITAL OF GREELEY LLC
Certification status
Active
Provider type (POS)
Hospital – Rehabilitation
Participating since
Mar 20, 2024
Last certification
Mar 20, 2024
Beds
42
Ownership / control type
Private (not for profit)
Organization structure
LLCProprietary
Enrollment address
6810 10TH St
Greeley, CO 80634-8254
Main/Primary Hospital Location
Hospital subgroups
Rehabilitation

National Provider Directory

National Provider Directory

Locations

6810 10th St
Greeley, CO 80634
Phone (970) 425-6770

Ownership & related parties

All disclosed owners & managing parties 6

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 Apr 21, 2021
Anthony F Misitano Individual Corporate Officer Apr 21, 2021
Pam Cubed LLC Organization, Enola, PA LLC, For-profit, Chain home office 5% Or Greater Direct Ownership Interest Apr 21, 2021
Wells Fargo Bank, N.a. Organization, Minneapolis, MN Financial institution 5% Or Greater Security Interest Jul 23, 2024
Ryan Fisher Individual W-2 Managing EmployeeCeo Mar 2, 2026
Brittany Misitano Individual 5% Or Greater Indirect Ownership Interest Apr 21, 2021

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 15

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

View all 15

Care Compare: Inpatient rehabilitation facility

Medicare Care Compare
Listed as
Pam Health Rehabilitation Hospital of GreeleyCCN 063039
Ownership
Non-profit
Certified
Mar 20, 2024
Medicare certification status
ActiveFrom the Provider of Services file

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
06D2289864Pam Health Rehabilitation Hospital of Greeley6810 West 10TH Street, Greeley, CO 80634Certificate of waiverSep 17, 2027

NPI Registry JSON

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

{
    "created_epoch": "1682553600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684454400000",
    "number": "1558059428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1828 GOOD HOPE RD STE 102",
            "city": "ENOLA",
            "state": "PA",
            "postal_code": "170251203",
            "telephone_number": "717-731-9660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6810 W 10TH ST",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "80634",
            "telephone_number": "717-731-9660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAM REHABILITATION HOSPITAL OF GREELEY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-27",
        "last_updated": "2023-05-19",
        "certification_date": "2023-05-09",
        "status": "A",
        "authorized_official_last_name": "MISITANO",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "717-731-9660"
    },
    "taxonomies": [
        {
            "code": "283X00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Hospital",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greeley, CO

Sources for this page

Verify at the official NPI Registry.