Active NPI
Noelle Selkow, PHD, ATC
- Athletic Trainer
- Normal, IL
National Provider Identifier
1124478714
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 096.003259
- Practice address
- 251C McOrmick Hall
Campus Box 5120
Normal, IL 61790 - Phone
- (716) 940-1212
- NPI assigned
- Jun 15, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 096.003259 | IL | Primary |
Addresses
Primary practice location
251C McOrmick Hall
Campus Box 5120
Normal, IL 61790
Mailing address
101 Ambrose Way
Normal, IL 61761-1821
Phone (716) 940-1212
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 Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 096.003259 | IL | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1465948800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1465948800000",
"number": "1124478714",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 AMBROSE WAY",
"city": "NORMAL",
"state": "IL",
"postal_code": "617611821",
"telephone_number": "716-940-1212"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "251C MCORMICK HALL",
"address_2": "CAMPUS BOX 5120",
"city": "NORMAL",
"state": "IL",
"postal_code": "61790",
"telephone_number": "716-940-1212"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SELKOW",
"first_name": "NOELLE",
"name_prefix": "Dr.",
"credential": "PHD, ATC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-06-15",
"last_updated": "2016-06-15",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "IL",
"license": "096.003259",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Normal, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.