NPIMap

Individual provider Active NPI

Katrina Lea Selsor, NP

  • Primary Care Nurse Practitioner
  • Sparta, MO
National Provider Identifier
1073020673
Registry record updated Oct 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
2018000302 Issued in MO
Practice address
155 Village Dr
Sparta, MO 65753-8104
Phone
(417) 634-4203
Fax
(417) 634-4505
NPI assigned
Jan 4, 2018
Last updated
Oct 16, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 2018000302 MO Primary

Addresses

Primary practice location

155 Village Dr
Sparta, MO 65753-8104

Mailing address

2183 Johnson Rd
Sparta, MO 65753-8813
Phone (417) 880-2505

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address KSELSOR@OCHHOSPITAL.HIN.US

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180108002431 MO Practitioner - Nurse Practitioner 8820357320 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sgoh Acquisition IncGroup PAC ID 5092616276, 95 clinicians

Practice addresses (Care Compare)

125 Main St
Noel, MO 64854-9124
Phone (417) 475-6151

155 Village Dr
Sparta, MO 65753-8104
Phone (417) 634-4203

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
2018000302MOMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sgoh Acquisition Inc Past Accepting new patients
Ozarks Medical Center Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: kselsor@ochhospital.hin.us

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1515024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697414400000",
    "number": "1073020673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2183 JOHNSON RD",
            "city": "SPARTA",
            "state": "MO",
            "postal_code": "657538813",
            "telephone_number": "417-880-2505",
            "fax_number": "417-634-4505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 VILLAGE DR",
            "city": "SPARTA",
            "state": "MO",
            "postal_code": "657538104",
            "telephone_number": "417-634-4203",
            "fax_number": "417-634-4505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SELSOR",
        "first_name": "KATRINA",
        "middle_name": "LEA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-04",
        "last_updated": "2023-10-16",
        "certification_date": "2023-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MO",
            "license": "2018000302",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "KSELSOR@OCHHOSPITAL.HIN.US",
            "affiliation": "N",
            "address_1": "155 Village Dr",
            "city": "Sparta",
            "state": "MO",
            "country_code": "US",
            "postal_code": "657538104",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Sparta, MO

Sources for this page

Verify at the official NPI Registry.