NPIMap

Organization Active NPI

Jeffrey W. Selby MD PSC

Doing business as The Lung Centre

  • Pulmonary Disease Physician
  • Newburgh, IN
National Provider Identifier
1114056710
Registry record updated Aug 31, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
35712 Issued in KY
Legal business name
JEFFREY W. SELBY MD PSC
Doing business as
The Lung Centre
Practice address
10288 W State Route 66
Newburgh, IN 47630-7952
Phone
(812) 853-5864
Fax
(812) 853-5610
NPI assigned
Mar 2, 2007
Last updated
Aug 31, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2011

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

Authorized official

Name
Dr. Jeffrey W Selby, MDNPI 1992791685
Title
Owner President
Phone
(812) 853-5864

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X NU
Acute Care Nurse Practitioner 363LA2100X 3005907 KY
Acute Care Nurse Practitioner 363LA2100X 71002793A IN
Pulmonary Disease Physician 207RP1001X 35712 KY Primary
Pulmonary Disease Physician 207RP1001X 01027862A IN

Addresses

Primary practice location

10288 W State Route 66
Newburgh, IN 47630-7952

Mailing address

PO Box 249
Newburgh, IN 47629-0249
Phone (812) 853-5864

Other identifiers 4

IdentifierTypeStateIssuer
7100026680MedicaidKY
000000307442OtherINANTHEM
200879610MedicaidIN
64754484MedicaidKY

Other names 1

  • The Lung Centre Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, KY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20060427000355 IN Part B Supplier - Clinic/Group Practice 4688684137 Receives reassigned benefits from 6 practitioners
Practice locations: Evansville, IN; Tell City, IN
O20070927000707 KY Part B Supplier - Clinic/Group Practice 4688684137 Receives reassigned benefits from 2 practitioners
Practice locations: Morganfield, KY

National Provider Directory

National Provider Directory

Locations

10288 W State Route 66
Newburgh, IN 47630
Phone (812) 583-5864

1 Hospital Rd
Tell City, IN 47586
Phone (812) 547-0135

319 8th St
Ste 3
Henderson, KY 42420
Phone (270) 844-1101

701 US Highway 60 E
Morganfield, KY 42437
Phone (270) 285-1100

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1172793600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1314748800000",
    "number": "1114056710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 249",
            "city": "NEWBURGH",
            "state": "IN",
            "postal_code": "476290249",
            "telephone_number": "812-853-5864",
            "fax_number": "812-853-5610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10288 W STATE ROUTE 66",
            "city": "NEWBURGH",
            "state": "IN",
            "postal_code": "476307952",
            "telephone_number": "812-853-5864",
            "fax_number": "812-853-5610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFREY W. SELBY MD PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-02",
        "last_updated": "2011-08-31",
        "status": "A",
        "authorized_official_last_name": "SELBY",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER PRESIDENT",
        "authorized_official_telephone_number": "812-853-5864",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "KY",
            "license": "3005907",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "IN",
            "license": "71002793A",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "KY",
            "license": "35712",
            "primary": true
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "IN",
            "license": "01027862A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100026680",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000307442",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200879610",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64754484",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Lung Centre",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Newburgh, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.