Selena Josephina Gardner, MHSC, RDN, LDN

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

LD.09278 Issued in OH

Practice address

5261 Sherry LN
Fairfield, OH 45014-3340

Phone

(513) 802-1184

NPI assigned

Nov 9, 2021

Sex

Female

Sole proprietor

No

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

• Selena Josephina Rodriguez Former name

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Nov 9, 2021.

{
    "created_epoch": "1636416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636416000000",
    "number": "1083370563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5261 SHERRY LN",
            "city": "FAIRFIELD",
            "state": "OH",
            "postal_code": "450143340",
            "telephone_number": "513-802-1184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5261 SHERRY LN",
            "city": "FAIRFIELD",
            "state": "OH",
            "postal_code": "450143340",
            "telephone_number": "513-802-1184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDNER",
        "first_name": "SELENA",
        "middle_name": "JOSEPHINA",
        "name_prefix": "Mrs.",
        "credential": "MHSC, RDN, LDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-09",
        "last_updated": "2021-11-09",
        "certification_date": "2021-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "OH",
            "license": "LD.09278",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DIETITIAN LICENSE",
            "identifier": "LD.09278",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICAN HEART ASSOCIATION BASIC LIFE SUPPORT",
            "identifier": "215415178089",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SERVSAFE",
            "identifier": "18083204",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DIETITIAN REGISTRATION",
            "identifier": "86174429",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Laptop",
            "affiliation": "N",
            "endpointDescription": "Macbook Air",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "Networking",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "5261 Sherry Ln",
            "city": "Fairfield",
            "state": "OH",
            "country_code": "US",
            "postal_code": "450143340",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "SELENA",
            "last_name": "RODRIGUEZ",
            "middle_name": "JOSEPHINA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Chantia Gaines, CNP
• Jacob Gainey
• Kaitlyn Galish, MS, CCC-SLP
• Maureen Suzanne Gallagher, MD
• Anisah Gardiner, PA-C
• Steve Gardner, O.D.
• Gary L Glynn DPM Inc.
• Amanda Katherine Gauthier, PA-C
• Donald James Gayda, D.O.
• Tiffany Geers

• All providers in Fairfield, OH
• Registered Dietitian in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2021; 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.