Individual provider Active NPI

Lana Louise Selby, F.N.P.

  • Family Nurse Practitioner
  • Safford, AZ
National Provider Identifier
1184650673
Registry record updated Jan 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
259120 Issued in AZ
Practice address
711 S 14TH Ave
Safford, AZ 85546-3337
Phone
(928) 424-2110
NPI assigned
Jun 25, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 7, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 259120 AR
Family Nurse Practitioner 363LF0000X 259120 AZ Primary

Addresses

Primary practice location

711 S 14TH Ave
Safford, AZ 85546-3337

Mailing address

711 S 14TH Ave
Safford, AZ 85546-3337
Phone (928) 424-2110

Other identifiers 1

IdentifierTypeStateIssuer
11846506MedicaidAZ

Electronic endpoints 3

TypeEndpointUseAffiliation
CONNECT URL lselby@gilahealth.com Health Information Exchange (HIE)
CONNECT URL lselby@gilahealth.com Health Information Exchange (HIE)
CONNECT URL lselby@gilahealth.com Health Information Exchange (HIE)

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200208000042 CA Order and Referring Only - Nurse Practitioner 5890689590

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11511CAMDAcupuncturist
259120ARMDFamily Nurse Practitioner
259120AZMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
San Joaquin Emergency Medical Associates Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: selby.lana.1@33093.direct.athenahealth.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1151193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641513600000",
    "number": "1184650673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 S 14TH AVE",
            "city": "SAFFORD",
            "state": "AZ",
            "postal_code": "855463337",
            "telephone_number": "928-424-2110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 S 14TH AVE",
            "city": "SAFFORD",
            "state": "AZ",
            "postal_code": "855463337",
            "telephone_number": "928-424-2110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SELBY",
        "first_name": "LANA",
        "middle_name": "LOUISE",
        "credential": "F.N.P.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-25",
        "last_updated": "2022-01-07",
        "certification_date": "2022-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "259120",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "259120",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "11846506",
            "state": "AZ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "lselby@gilahealth.com",
            "affiliation": "N",
            "endpointDescription": "provider work email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1492 S 20th Ave",
            "city": "Safford",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "855464052",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "lselby@gilahealth.com",
            "affiliation": "N",
            "endpointDescription": "provider work email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "save way",
            "address_1": "711 S 14th Ave",
            "city": "Safford",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "855463337",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "lselby@gilahealth.com",
            "affiliation": "N",
            "endpointDescription": "provider work email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "walmart",
            "address_1": "711 S 14th Ave",
            "city": "Safford",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "855463337",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Safford, AZ

Sources for this page

Verify at the official NPI Registry.