Active NPI
Nancy Selph
- Social Worker
- Jackson, MS
National Provider Identifier
1174064547
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- W1590
- Practice address
- 2624 Southerland St
Jackson, MS 39216-4825 - Phone
- (601) 974-3093
- Fax
- (601) 366-4287
- NPI assigned
- Mar 17, 2017
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Social Worker | 104100000X | W1590 | MS | Primary |
Addresses
Primary practice location
2624 Southerland St
Jackson, MS 39216-4825
Mailing address
2624 Southerland St
Jackson, MS 39216-4825
Phone (601) 974-3093
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| W1590 | MS | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bethany Christian Services | Social Worker | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Social Worker
- Jackson, MS
- NPI 1144656943
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1489708800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1489708800000",
"number": "1174064547",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2624 SOUTHERLAND ST",
"city": "JACKSON",
"state": "MS",
"postal_code": "392164825",
"telephone_number": "601-974-3093",
"fax_number": "601-366-4287"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2624 SOUTHERLAND ST",
"city": "JACKSON",
"state": "MS",
"postal_code": "392164825",
"telephone_number": "601-974-3093",
"fax_number": "601-366-4287"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SELPH",
"first_name": "NANCY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-03-17",
"last_updated": "2017-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MS",
"license": "W1590",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jackson, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.