NPIMap

Organization Active NPI

Select Specialty Hospital Belhaven LLC

  • Long Term Care Hospital
  • Jackson, MS
National Provider Identifier
1619326014
Registry record updated Sep 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care HospitalTaxonomy code 282E00000X
Legal business name
SELECT SPECIALTY HOSPITAL BELHAVEN LLC
Practice address
1225 N State St
Jackson, MS 39202-2064
Phone
(717) 972-1100
NPI assigned
Jun 7, 2016
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
John Duggan
Title
Vice President
Phone
(717) 972-1100

Specialties & licenses 1

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

Addresses

Primary practice location

1225 N State St
Jackson, MS 39202-2064

Mailing address

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

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160830000587 MS Part A Provider - Hospital 1850686890 Practice locations: Jackson, MS

Hospital certification: CCN 252003

Legal name
SELECT SPECIALTY HOSPITAL BELHAVEN LLC
Doing business as
SELECT SPECIALTY HOSPITAL-BELHAVEN
Certification status
Active
Provider type (POS)
Hospital – Long-term
Participating since
Aug 17, 1993
Last certification
Jan 4, 2018
Beds
25
Ownership / control type
Private (for profit)
Most recent change of ownership
Aug 2, 2016 (1 total)
Organization structure
LLCProprietary
Incorporated
Apr 20, 2016 in DE
Enrollment address
1225 North State Street
Jackson, MS 39202-2064
Other Hospital Practice Location
Hospital subgroups
Long-term

Care Compare: Long-term care hospital

Medicare Care Compare
Listed as
Select Specialty Hospital - BelhavenCCN 252003
Ownership
For profit
Certified
Aug 17, 1993
Medicare certification status
ActiveFrom the Provider of Services file
Beds
25

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
25D2115295Select Specialty Hospital - Belhaven, LLC1225 N State St, Jackson, MS 39202AccreditationJun 20, 2027

National Provider Directory

National Provider Directory

Member of 2

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

Locations

1225 N State St
Fl 5
Jackson, MS 39202
Phone (601) 420-0141

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 Medical Corporation Organization, Mechanicsburg, PA Corporation, For-profit 5% Or Greater Indirect Ownership Interest Aug 2, 2016 100%
Operational/Managerial Control Aug 2, 2016 100%
Thomas Mullin Individual Corporate Officer Sep 4, 2025
Select Specialty Hospital - Jackson Inc Organization, Mechanicsburg, PA Corporation, For-profit 5% Or Greater Direct Ownership Interest Aug 2, 2016 100%
John Saich Individual Corporate Officer Sep 4, 2025
Robert Breighner Individual W-2 Managing EmployeeCompliance Officer Sep 4, 2025
Select Specialty Hospitals Inc Organization, Mechanicsburg, PA Corporation, For-profit 5% Or Greater Indirect Ownership Interest Aug 2, 2016 100%
Michael Malatesta Individual Corporate Officer Sep 4, 2025
Robert Kido Individual Corporate Officer Sep 4, 2025
John Duggan Individual Corporate Officer Aug 2, 2016
Corporate Director Sep 4, 2025
Billy Bourn Individual Corporate OfficerCeo Jan 23, 2023
W-2 Managing EmployeeCeo Jan 23, 2023
Operational/Managerial ControlCeo Jan 23, 2023

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

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 2

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

Affiliated clinicians 1

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": "1465257600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757462400000",
    "number": "1619326014",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 N STATE ST",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392022064",
            "telephone_number": "717-972-1100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SELECT SPECIALTY HOSPITAL BELHAVEN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-07",
        "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"
    },
    "taxonomies": [
        {
            "code": "282E00000X",
            "taxonomy_group": "",
            "desc": "Long Term Care Hospital",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

Verify at the official NPI Registry.