Jimmy Selanders Jr.

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

License

200129910A Issued in OK

Practice address

32300 S 625 Rd
Grove, OK 74344-6285

Phone

(918) 786-2930

Fax

(918) 786-5985

NPI assigned

Jan 15, 2015

Last updated

Jan 15, 2015By the provider in NPPES

Sex

Male

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• House of Hope Inc

  • Substance Abuse Rehabilitation Facility
  • Grove, OK
  • NPI 1275848384
  NPD (past)
• House of Hope,Inc.

  • Substance Abuse Rehabilitation Facility
  • Grove, OK
  • NPI 1609995356
  NPD (past)

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

{
    "created_epoch": "1421280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421280000000",
    "number": "1265821102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 451585",
            "city": "GROVE",
            "state": "OK",
            "postal_code": "743451585",
            "telephone_number": "918-786-2930",
            "fax_number": "918-786-5985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32300 S 625 RD",
            "city": "GROVE",
            "state": "OK",
            "postal_code": "743446285",
            "telephone_number": "918-786-2930",
            "fax_number": "918-786-5985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SELANDERS",
        "first_name": "JIMMY",
        "name_suffix": "Jr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-01-15",
        "last_updated": "2015-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "OK",
            "license": "200129910A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Caitlin Schaede, D.O.
• Angela Schafer
• Kyle J Schauf, MD
• Elizabeth Scott, CRS
• Tamara Kay Sears, LBSW
• Seneca Cayuga Nation
• Steven Graham Shackelford
• Shawn Michael Anderson MD LLC (Anderson Family Clinic)
• Bryan M Sheehan, DPM
• Ashley Shelley

• Mental Health Clinic/Center (Including Community Mental Health Center) in Grove, OK
• Providers in Grove, OK by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2015; 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.