Selene Medical Clinic PLLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

SELENE MEDICAL CLINIC PLLC

Practice address

155 N California St Apt 211
Missoula, MT 59801-1766

Phone

(817) 404-7481

NPI assigned

May 31, 2024

Organization subpart

No

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

Authorized official

Name

Jennifer Shepard, MD

Title

Owner

Phone

(817) 404-7481

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MT

Enrollment records 1

Locations

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

{
    "created_epoch": "1717113600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717113600000",
    "number": "1225878614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 N CALIFORNIA ST APT 211",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598011766",
            "telephone_number": "817-404-7481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 N CALIFORNIA ST APT 211",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598011766",
            "telephone_number": "817-404-7481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SELENE MEDICAL CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-31",
        "last_updated": "2024-05-31",
        "certification_date": "2024-05-31",
        "status": "A",
        "authorized_official_last_name": "SHEPARD",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "817-404-7481",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Morgan Sedahl
• Maureen Seel
• Jade Seifert
• Susan Marie Selbach, MD
• Nancy Seldin, EDD, LPC
• Suzanne Blaze Selestow
• D. Kate Sells, LCPC, LAC
• Paul D Sells, LCSW LAC
• Jill Ann Selman
• Daniel Selvig, M.D.

• Internal Medicine Physician in Missoula, MT
• Providers in Missoula, MT by specialty
• Internal Medicine Physician in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.