NPIMap

Organization Active NPI

Pam Specialty Hospital of Rocky Mount LLC

Doing business as PAM Specialty Hospital of Rocky Mount

  • Long Term Care Hospital
  • Rocky Mount, NC
National Provider Identifier
1861049371
Registry record updated Sep 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care HospitalTaxonomy code 282E00000X
Legal business name
PAM SPECIALTY HOSPITAL OF ROCKY MOUNT LLC
Doing business as
PAM Specialty Hospital of Rocky Mount
Practice address
1051 Noell LN
Rocky Mount, NC 27804-1761
Phone
(252) 451-2300
NPI assigned
Aug 20, 2019
Last updated
Sep 28, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2021

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Special Hospital 284300000X NU
Long Term Care Hospital 282E00000X NU Primary

Addresses

Primary practice location

1051 Noell LN
Rocky Mount, NC 27804-1761

Mailing address

1828 Good Hope Rd
Enola, PA 17025-1203

Other names 1

  • PAM Specialty Hospital of Rocky Mount Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20191107002632 NC Part A Provider - Hospital 6406288778 Practice locations: Rocky Mount, NC

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1861049371. Details of each certification follow.

Hospital certification: CCN 342013

Legal name
PAM SPECIALTY HOSPITAL OF ROCKY MOUNT LLC
Certification status
Active
Provider type (POS)
Hospital – Long-term
Participating since
Jul 1, 2000
Last certification
Jan 28, 2010
Beds
50
Ownership / control type
Private (for profit)
Most recent change of ownership
May 31, 2013 (1 total)
Organization structure
LLCProprietary
Incorporated
Aug 9, 2019 in PA
Enrollment address
1051 Noell LN
Rocky Mount, NC 27804-1761
Main/Primary Hospital Location
Hospital subgroups
Long-term

Care Compare: Long-term care hospital

Medicare Care Compare
Listed as
Pam Specialty Hospital of Rocky MountCCN 342013 · All quality measures
Ownership
For profit
Certified
Jul 1, 2000
Medicare certification status
ActiveFrom the Provider of Services file
Beds
50

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
34D1012218Pam Specialty Hospital of Rocky Mount1051 Noell Lane, Rocky Mount, NC 27804AccreditationDec 7, 2026

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 7

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 OfficerVice President/Treasurer Aug 9, 2019
Anthony F Misitano Individual Corporate OfficerPresident Aug 9, 2019
Pam Cubed LLC Organization, Enola, PA LLC, For-profit, Chain home office 5% Or Greater Indirect Ownership Interest Sep 30, 2019 100%
Wells Fargo Bank, N.a. Organization, Minneapolis, MN Financial institution, For-profit 5% Or Greater Security Interest Jul 23, 2024
Brittany Misitano Individual 5% Or Greater Indirect Ownership InterestVice President/Secretary Sep 30, 2019 73.5%
Corporate OfficerVice President/Secretary Aug 9, 2019
Robyn Perkerson Individual W-2 Managing EmployeeCeo Sep 30, 2019
Pam Cubed Specialty Hospitals LLC Organization, Enola, PA LLC, Holding company, For-profit 5% Or Greater Direct Ownership Interest Sep 30, 2019 100%

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

Affiliated clinicians 2

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": "1566259200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1632787200000",
    "number": "1861049371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1828 GOOD HOPE RD",
            "city": "ENOLA",
            "state": "PA",
            "postal_code": "170251203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1051 NOELL LN",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "278041761",
            "telephone_number": "252-451-2300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAM SPECIALTY HOSPITAL OF ROCKY MOUNT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-20",
        "last_updated": "2021-09-28",
        "certification_date": "2021-09-28",
        "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": "284300000X",
            "taxonomy_group": "",
            "desc": "Special Hospital",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "282E00000X",
            "taxonomy_group": "",
            "desc": "Long Term Care Hospital",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PAM Specialty Hospital of Rocky Mount",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PAM Specialty Hospital of Rocky Mount",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rocky Mount, NC

Sources for this page

Verify at the official NPI Registry.