NPIMap

Organization Active NPI

Warm Springs Specialty Hospital of San Antonio, LLC

Doing business as PAM Specialty Hospital of San Antonio

  • Long Term Care Hospital
  • San Antonio, TX
National Provider Identifier
1629037163
Registry record updated Aug 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care HospitalTaxonomy code 282E00000X
License
100172 Issued in TX
Legal business name
WARM SPRINGS SPECIALTY HOSPITAL OF SAN ANTONIO, LLC
Doing business as
PAM Specialty Hospital of San Antonio
Practice address
5418 N Loop 1604 W
San Antonio, TX 78249-4558
Phone
(210) 600-4600
Fax
(210) 600-4657
NPI assigned
Mar 22, 2006
Last updated
Aug 3, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2023

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

Authorized official

Name
Mr. Thomas C. Kanavy
Title
President
Phone
(717) 731-9660

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Long Term Care Hospital 282E00000X 100172 TX Primary

Addresses

Primary practice location

5418 N Loop 1604 W
San Antonio, TX 78249-4558

Mailing address

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

Other identifiers 3

IdentifierTypeStateIssuer
326690001MedicaidTX
HH1088OtherTXBLUE CROSS PROVIDER #
326690002MedicaidTX

Other names 1

  • PAM Specialty Hospital of San Antonio Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120925000448 TX Part A Provider - Hospital 5395994990 Practice locations: San Antonio, TX

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1629037163. Details of each certification follow.

Hospital certification: CCN 452090

Legal name
WARM SPRINGS SPECIALTY HOSPITAL OF SAN ANTONIO LLC
Doing business as
PAM SPECIALTY HOSPITAL OF SAN ANTONIO
Certification status
Active
Provider type (POS)
Hospital – Long-term
Participating since
Nov 20, 2003
Last certification
Sep 7, 2024
Beds
26
Ownership / control type
Private (for profit)
Most recent change of ownership
Aug 18, 2012 (1 total)
Organization structure
LLCProprietary
Incorporated
Jun 11, 2012 in DE
Enrollment address
5418 N Loop 1604 W
San Antonio, TX 78249-4558
Main/Primary Hospital Location
Hospital subgroups
Long-term

Care Compare: Long-term care hospital

Medicare Care Compare
Listed as
Pam Specialty Hospital of San AntonioCCN 452090 · All quality measures
Ownership
For profit
Certified
Nov 20, 2003
Medicare certification status
ActiveFrom the Provider of Services file
Beds
26

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
45D1018491Pam Specialty Hospital of San Antonio5418 N Loop 1604 W, San Antonio, TX 78249AccreditationSep 19, 2027

National Provider Directory

National Provider Directory

Locations

11407 Wayland Way
San Antonio, TX 78233
Phone (210) 232-1023

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
Ba Healthcare Holdings, LLC Organization, Enola, PA For-profit 5% Or Greater Indirect Ownership Interest Aug 18, 2012 50%
Karick E Stober Individual Corporate OfficerVP/Treasurer Apr 20, 2016
Anthony F Misitano Individual 5% Or Greater Indirect Ownership Interest Aug 18, 2012 50%
Corporate DirectorMember of Board of Managers Aug 8, 2012
Pam Cubed LLC Organization, Enola, PA LLC, For-profit, Chain home office 5% Or Greater Indirect Ownership Interest Jul 23, 2024
John E Bauer Individual Corporate OfficerVP/Secretary Aug 18, 2012
Sheila Bollier Individual W-2 Managing EmployeeCeo Mar 2, 2026
Wells Fargo Bank, N.a. Organization, Minneapolis, MN Financial institution 5% Or Greater Security Interest Jul 23, 2024
Pam Cubed LLC Organization, Enola, PA LLC, For-profit 5% Or Greater Direct Ownership Interest Aug 18, 2012 100%
Brittany Misitano Individual 5% Or Greater Indirect Ownership Interest Jul 23, 2024

Facilities with the same owner 42

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

View all 42

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

Affiliated clinicians 10

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": "1142985600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691020800000",
    "number": "1629037163",
    "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",
            "fax_number": "717-731-9665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5418 N LOOP 1604 W",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782494558",
            "telephone_number": "210-600-4600",
            "fax_number": "210-600-4657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WARM SPRINGS SPECIALTY HOSPITAL OF SAN ANTONIO, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-22",
        "last_updated": "2023-08-03",
        "certification_date": "2023-08-03",
        "status": "A",
        "authorized_official_last_name": "KANAVY",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "717-731-9660",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "282E00000X",
            "taxonomy_group": "",
            "desc": "Long Term Care Hospital",
            "state": "TX",
            "license": "100172",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "326690001",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS PROVIDER #",
            "identifier": "HH1088",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "326690002",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PAM Specialty Hospital of San Antonio",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.