Individual provider Active NPI

Amanda Jean Selseth, PHARMD

  • Pharmacist
  • Saint Paul, MN
National Provider Identifier
1114204880
Registry record updated Nov 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
118268 Issued in MN
Practice address
2099 Ford Pkwy
Saint Paul, MN 55116-1814
Phone
(651) 414-3882
NPI assigned
Nov 9, 2011
Last updated
Nov 9, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 118268 MN Primary

Addresses

Primary practice location

2099 Ford Pkwy
Saint Paul, MN 55116-1814

Mailing address

1745 Hubbard Ave
Saint Paul, MN 55104-1133
Phone (651) 646-8986

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
118268MNMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co Past Accepting new patients
Walgreen Co PastSince Apr 17, 2022 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1320796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320796800000",
    "number": "1114204880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1745 HUBBARD AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551041133",
            "telephone_number": "651-646-8986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2099 FORD PKWY",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551161814",
            "telephone_number": "651-414-3882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SELSETH",
        "first_name": "AMANDA",
        "middle_name": "JEAN",
        "name_prefix": "Mrs.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-09",
        "last_updated": "2011-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MN",
            "license": "118268",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2011; 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.