Kelsey Self

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

1543 County Road 3350
Clarksville, AR 72830-8162

Phone

(479) 647-8063

NPI assigned

Apr 21, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1398038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398038400000",
    "number": "1104246966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1543 COUNTY ROAD 3350",
            "city": "CLARKSVILLE",
            "state": "AR",
            "postal_code": "728308162",
            "telephone_number": "479-647-8063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1543 COUNTY ROAD 3350",
            "city": "CLARKSVILLE",
            "state": "AR",
            "postal_code": "728308162",
            "telephone_number": "479-647-8063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SELF",
        "first_name": "KELSEY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-04-21",
        "last_updated": "2014-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "AR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katheren Sax
• Andrea Schluterman
• Sussannah Marie Schluterman, OT-A
• Sarabeth Schmoker
• Logan Schneider, RECOVERY ASSISTANT
• Lisa Noelle Senter, AT
• Abbigale Sharp
• Destiny Sharp
• Brittany Shaw
• Daniel Shaw, RECOVERY ASSISTANT

• Case Manager/Care Coordinator in Clarksville, AR
• Providers in Clarksville, AR by specialty
• Case Manager/Care Coordinator in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2014; 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.