NPIMap

Organization Active NPI

Monty R. Sellon M.D.

  • Family Medicine Physician
  • Fremont, NE
National Provider Identifier
1073684239
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
17703 Issued in NE
Legal business name
MONTY R. SELLON M.D.
Practice address
350 W 23Rd St
Suite C
Fremont, NE 68025-2592
Phone
(402) 721-5727
Fax
(402) 753-6096
NPI assigned
Nov 10, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Diane Vasa
Title
Office Manager
Phone
(402) 753-6002

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 17703 NE Primary

Addresses

Primary practice location

350 W 23Rd St
Suite C
Fremont, NE 68025-2592

Mailing address

350 W 23Rd St
Suite C
Fremont, NE 68025-2592
Phone (402) 721-5727

Other names 1

  • Monty Sellon M.D. Doing business as

National Provider Directory

National Provider Directory

Locations

350 W 23rd St
Ste C
Fremont, NE 68025
Phone (402) 721-5727

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1163116800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1073684239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 W 23RD ST",
            "address_2": "SUITE C",
            "city": "FREMONT",
            "state": "NE",
            "postal_code": "680252592",
            "telephone_number": "402-721-5727",
            "fax_number": "402-753-6096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 W 23RD ST",
            "address_2": "SUITE C",
            "city": "FREMONT",
            "state": "NE",
            "postal_code": "680252592",
            "telephone_number": "402-721-5727",
            "fax_number": "402-753-6096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONTY R. SELLON M.D.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "VASA",
        "authorized_official_first_name": "DIANE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "402-753-6002"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "NE",
            "license": "17703",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Monty Sellon M.D.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fremont, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.