Individual provider Active NPI

Eric J Selle, D.C.

  • Chiropractor
  • Cary, NC
National Provider Identifier
1265663033
Registry record updated Aug 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4468 Issued in NC
Practice address
1750 NW Maynard Rd Ste 112
Cary, NC 27513-3402
Phone
(919) 617-1164
Fax
(919) 617-1164
NPI assigned
Jul 28, 2009
Last updated
Aug 22, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4468 NC Primary

Addresses

Primary practice location

1750 NW Maynard Rd Ste 112
Cary, NC 27513-3402

Mailing address

1750 NW Maynard Rd Ste 112
Cary, NC 27513-3402
Phone (919) 617-1164

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161004000433 NC Practitioner - Chiropractic 6305976044 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1750 NW Maynard Rd
Suite 112
Cary, NC 27513-3402
Phone (919) 617-1164

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4468NCMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Hio Inc Chiropractor CurrentSince Aug 23, 2016 Accepting new patients
Simmons Specific Chiropractic P C Chiropractor Past Accepting new patients

Locations

1750 NW Maynard Rd
Ste 112
Cary, NC 27513
Phone (919) 617-1164

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": "1248739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471824000000",
    "number": "1265663033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1750 NW MAYNARD RD STE 112",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275133402",
            "telephone_number": "919-617-1164",
            "fax_number": "919-617-1164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1750 NW MAYNARD RD STE 112",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275133402",
            "telephone_number": "919-617-1164",
            "fax_number": "919-617-1164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SELLE",
        "first_name": "ERIC",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-28",
        "last_updated": "2016-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "4468",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cary, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.