Individual provider Active NPI

Richard Seldeen, PMHNP

  • Primary Care Nurse Practitioner
  • Lewisville, TX
National Provider Identifier
1326614223
Registry record updated Mar 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
1035109 Issued in TX
Practice address
1450 Valley Ridge Blvd Apt 3309
Lewisville, TX 75077-3752
Phone
(214) 460-1212
NPI assigned
Jun 1, 2021
Last updated
Mar 8, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 1035109 TX
Primary Care Nurse Practitioner 363LP2300X 1035109 TX Primary

Addresses

Primary practice location

1450 Valley Ridge Blvd Apt 3309
Lewisville, TX 75077-3752

Mailing address

1450 Valley Ridge Blvd Apt 3309
Lewisville, TX 75077-3752
Phone (214) 460-1212

Other practice location 1

14275 Midway Rd Ste 200
Addison, TX 75001-3618
Phone (214) 460-1212

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, MO2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210821000314 TX Practitioner - Nurse Practitioner 6709281207 Reassigns benefits to 2 organizations
I20230515000712 MO Practitioner - Nurse Practitioner 6709281207 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1035109TXMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Nurocoach Medical Group PLLC CurrentSince Aug 18, 2022 Accepting new patients
Gracious Minds Counseling and Supervision Inc. CurrentSince Aug 18, 2022 Accepting new patients
Acclaim Physician Group, Inc CurrentSince Aug 1, 2021 Accepting new patients

Locations

7280 NW 87th Ter
Ste C210
Kansas City, MO 64153
Phone (816) 608-3339

1350 S Main St
Fl 1
Fort Worth, TX 76104
Phone (817) 702-3701

1500 S Main St
Ft Worth, TX 76104
Phone (817) 921-3431

200 W Magnolia Ave
Ste 201
Ft Worth, TX 76104
Phone (817) 702-2450

2800 Kirby Dr
Ste A110
Houston, TX 77098

101 Southwestern Blvd
Ste 200
Sugar Land, TX 77478
Phone (346) 298-3790

Organizations & group practices 3

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": "1622505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709856000000",
    "number": "1326614223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1450 VALLEY RIDGE BLVD APT 3309",
            "city": "LEWISVILLE",
            "state": "TX",
            "postal_code": "750773752",
            "telephone_number": "214-460-1212",
            "fax_number": "817-702-2140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1450 VALLEY RIDGE BLVD APT 3309",
            "city": "LEWISVILLE",
            "state": "TX",
            "postal_code": "750773752",
            "telephone_number": "214-460-1212"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14275 Midway Rd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Addison",
            "state": "TX",
            "postal_code": "750013618",
            "country_code": "US",
            "telephone_number": "214-460-1212",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SELDEEN",
        "first_name": "RICHARD",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-01",
        "last_updated": "2024-03-08",
        "certification_date": "2024-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "1035109",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "TX",
            "license": "1035109",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewisville, TX

Sources for this page

Verify at the official NPI Registry.