Individual provider Active NPI

Selena D Saulsbery

  • Registered Dietitian
  • Saint Louis, MO
National Provider Identifier
1326660325
Registry record updated Jun 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
2021020771 Issued in MO
Practice address
1 Jefferson Barracks Dr
Saint Louis, MO 63125-4181
Phone
(314) 652-4100
NPI assigned
May 12, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nutritionist 133N00000X
Registered Dietitian 133V00000X
Registered Dietitian 133V00000X 2021020771 MO Primary

Addresses

Primary practice location

1 Jefferson Barracks Dr
Saint Louis, MO 63125-4181

Mailing address

1614 N Berry Rd
Saint Louis, MO 63119-1208
Phone (314) 283-4315

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2021020771MOMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1589241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623542400000",
    "number": "1326660325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1614 N BERRY RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631191208",
            "telephone_number": "314-283-4315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 JEFFERSON BARRACKS DR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631254181",
            "telephone_number": "314-652-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAULSBERY",
        "first_name": "SELENA",
        "middle_name": "D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-12",
        "last_updated": "2021-06-13",
        "certification_date": "2021-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MO",
            "license": "2021020771",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2021; 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.