Select Specialty Hospital - Bloomington Inc

Primary specialty

Long Term Care HospitalTaxonomy code 282E00000X

License

003061 Issued in IN

Legal business name

SELECT SPECIALTY HOSPITAL - BLOOMINGTON INC

Practice address

601 W 2ND St
4TH Floor
Bloomington, IN 47402-2317

Phone

(812) 353-2002

Fax

(812) 353-2001

NPI assigned

Jul 12, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Michael E. Tarvin

Title

Vice President

Phone

(717) 972-1139

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Hospital certification: CCN 150151

Legal name

SELECT SPECIALTY HOSPITAL-BLOOMINGTON

Certification status

Terminated Other: provider status change, Aug 1, 2002

Provider type (POS)

Hospital – Short-term

Participating since

Jan 7, 2002

Last certification

Jan 7, 2002

Beds

30

Ownership / control type

Private (for profit)

Facility address

601 W Second Street, 4TH Floor
Bloomington, IN 47402

Hospital certification: CCN 152019

Legal name

SELECT SPECIALTY HOSPITAL-BLOOMINGTON

Certification status

Terminated Voluntary: merger or closure, Sep 24, 2007

Provider type (POS)

Hospital – Long-term

Participating since

Jan 7, 2002

Last certification

Mar 30, 2004

Beds

30

Ownership / control type

Private (for profit)

Facility address

601 W Second Street, 4TH Floor
Bloomington, IN 47402

Locations

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

{
    "created_epoch": "1121126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205193600000",
    "number": "1831197904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4716 OLD GETTYSBURG RD",
            "address_2": "LEGAL DEPT.",
            "city": "MECHANICSBURG",
            "state": "PA",
            "postal_code": "170554325",
            "telephone_number": "717-972-1139",
            "fax_number": "717-975-9981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 W 2ND ST",
            "address_2": "4TH FLOOR",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474022317",
            "telephone_number": "812-353-2002",
            "fax_number": "812-353-2001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SELECT SPECIALTY HOSPITAL - BLOOMINGTON INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-12",
        "last_updated": "2008-03-11",
        "status": "A",
        "authorized_official_last_name": "TARVIN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "717-972-1139",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "282E00000X",
            "taxonomy_group": "",
            "desc": "Long Term Care Hospital",
            "state": "IN",
            "license": "003061",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS IN",
            "identifier": "000000227863",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Riowena Suyu Seah, MD
• Emily Searfoss
• Rebekah Seda, CNM
• Rose M Seguin, NP
• Andrew James Seier, MD
• Andrew Sellers
• Daniel Alexander Selo, MD
• Daniel Selvaggi, L.M.T.
• Griffin Semona
• Monica Senger, DMD

• Long Term Care Hospital in Bloomington, IN
• Providers in Bloomington, IN by specialty
• Long Term Care Hospital in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.