Individual provider Active NPI

Selena Anthony, WHNP-BC, FNP-C

  • Women's Health Nurse Practitioner
  • Austell, GA
National Provider Identifier
1144648528
Registry record updated Apr 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
RN1981374 Issued in GA
Practice address
1700 Hospital South Dr Ste 301
Austell, GA 30106-8116
Phone
(770) 819-9211
NPI assigned
Apr 2, 2014
Last updated
Apr 4, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN198374 GA
Women's Health Nurse Practitioner 363LW0102X RN1981374 GA Primary
Registered Nurse 163W00000X RN198374 GA

Addresses

Primary practice location

1700 Hospital South Dr Ste 301
Austell, GA 30106-8116

Mailing address

4400 Brownsville Rd Ste 105-3620
Powder Springs, GA 30127-3199
Phone (770) 819-9211

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150804004549 GA Practitioner - Nurse Practitioner 8820302870 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Obstetrix Medical Group of Atlanta, LLCGroup PAC ID 8527105253, 4 clinicians

Practice addresses (Care Compare)

1700 Hospital S Dr
Suite 301
Austell, GA 30106-8116
Phone (770) 819-9211

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN198374GAMDFamily Nurse Practitioner
RN1981374GAMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Obstetrix Medical Group of Atlanta, LLC CurrentSince Mar 15, 2022 Accepting new patients
Pediatrix Medical Group of Georgia, P.C. PastSince Feb 24, 2022 Accepting new patients

Locations

1968 Ptree Rd NW
Atlanta, GA 30309
Phone (404) 605-2222

1700 Hospital South Dr
Ste 301
Austell, GA 30106
Phone (770) 819-9211

Interoperability endpoints

  • Direct secure messaging: selena.anthonywhnp.p40@direct.mednax.nextgenshare.com

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": "1396396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680566400000",
    "number": "1144648528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4400 BROWNSVILLE RD STE 105-3620",
            "city": "POWDER SPRINGS",
            "state": "GA",
            "postal_code": "301273199",
            "telephone_number": "770-819-9211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 HOSPITAL SOUTH DR STE 301",
            "city": "AUSTELL",
            "state": "GA",
            "postal_code": "301068116",
            "telephone_number": "770-819-9211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTHONY",
        "first_name": "SELENA",
        "credential": "WHNP-BC, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-02",
        "last_updated": "2023-04-04",
        "certification_date": "2023-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN198374",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "GA",
            "license": "RN1981374",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "GA",
            "license": "RN198374",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austell, GA

Sources for this page

Verify at the official NPI Registry.