Selah Therapeutics, LLC

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

Legal business name

SELAH THERAPEUTICS, LLC

Practice address

8417 Crossland Loop
Montgomery, AL 36117-8485

Phone

(205) 249-1857

Fax

(334) 612-7172

NPI assigned

Aug 13, 2021

Organization subpart

No

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

Authorized official

Name

Mr. Ezekiel J Griffin, OTR/LNPI 1952988438

Title

Owner

Phone

(205) 249-1857

Specialties & licenses 1

Addresses

Other names 1

• Selah Therapeutics, LLC Other name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in AL

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ezekiel J Griffin, OT/L

  • Occupational Therapist
  • Montgomery, AL
  • NPI 1952988438
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1628812800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1628812800000",
    "number": "1336814037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8417 CROSSLAND LOOP",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361178485",
            "telephone_number": "205-249-1857",
            "fax_number": "334-612-7172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8417 CROSSLAND LOOP",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361178485",
            "telephone_number": "205-249-1857",
            "fax_number": "334-612-7172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SELAH THERAPEUTICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-13",
        "last_updated": "2021-08-13",
        "certification_date": "2021-08-13",
        "status": "A",
        "authorized_official_last_name": "GRIFFIN",
        "authorized_official_first_name": "EZEKIEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "205-249-1857",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "OTR/L"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://selahtherapeutics.clientsecure.me/",
            "affiliation": "N",
            "endpointDescription": "Simple Practice",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Patient portal",
            "address_1": "8417 Crossland Loop",
            "city": "Montgomery",
            "state": "AL",
            "country_code": "US",
            "postal_code": "361178485",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Selah Therapeutics, LLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Occupational Therapist in Montgomery, AL
• Providers in Montgomery, AL by specialty
• Occupational Therapist in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.