Selena Marie Gonzalez

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

173264 Issued in OH

Practice address

1139 W 20TH St
Lorain, OH 44052-3864

Phone

(440) 406-7783

NPI assigned

May 28, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Inspiring Angel Care

  • Home Health Agency
  • Elyria, OH
  • NPI 1437918067
  NPD Authorized official

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

{
    "created_epoch": "1653696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653696000000",
    "number": "1245979285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1139 W 20TH ST",
            "city": "LORAIN",
            "state": "OH",
            "postal_code": "440523864",
            "telephone_number": "440-406-7783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1139 W 20TH ST",
            "city": "LORAIN",
            "state": "OH",
            "postal_code": "440523864",
            "telephone_number": "440-406-7783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "SELENA",
        "middle_name": "MARIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-05-28",
        "last_updated": "2022-05-28",
        "certification_date": "2022-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "173264",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tiffany Madison Angelica Gomez, PA-C
• Gesenia Gonzalez
• Hannah Grace Gonzalez, MT-BC
• Laura Gonzalez
• Sabrina Gonzalez
• Lisa Kay Goodwin, OCPS, CDCA, TTS
• Christopher Ryan Gordon
• Jody Laine Gordon, DO
• Lynn Marie Gordon, RN, BSN, CNP
• Robert F. Gradisek, O.D.

• Licensed Practical Nurse in Lorain, OH
• Providers in Lorain, OH by specialty
• Licensed Practical Nurse in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.