NPIMap

Individual provider Active NPI

Michael Grant Selby, M.D.

  • Nephrology Physician
  • Branson, MO
National Provider Identifier
1346494192
Registry record updated Jul 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
2014008959 Issued in MO
Practice address
101 Skaggs Rd, Ste 302
Branson, MO 65616-2062
Phone
(417) 334-8288
Fax
(417) 334-6966
NPI assigned
Nov 6, 2008
Last updated
Jul 8, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 2014008959 MO
Nephrology Physician 207RN0300X 2014008959 MO Primary

Addresses

Primary practice location

101 Skaggs Rd, Ste 302
Branson, MO 65616-2062

Mailing address

101 Skaggs Rd Ste 302
Branson, MO 65616-2062
Phone (417) 334-8288

Other practice location 1

1409 Gladden Street
Harrison, AR 72601-2236
Phone (870) 204-6683

Other identifiers 2

IdentifierTypeStateIssuer
212205001MedicaidAR
2000014075MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, AR2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20140602000814 MO Practitioner - NephrologyPractitioner - Internal Medicine 8426195041 Reassigns benefits to 1 organization
I20210122002231 AR Practitioner - NephrologyPractitioner - Internal Medicine 8426195041 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
University of Missouri, Columbia School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Branson Nephrology LLCGroup PAC ID 0840250585, 6 clinicians

Practice addresses (Care Compare)

101 Skaggs Rd
Suite 302
Branson, MO 65616-2062
Phone (417) 334-8288

1409 Gladden St
Harrison, AR 72601-2236
Phone (870) 204-6686

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.48 of 100Reported as individual
Quality
49.25
Improvement activities
40
Cost
82.09

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2014008959MOMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Joplin LLC PastSince Jan 2, 2016 Accepting new patients
Branson Kidney Center LLC PastSince Jul 1, 2023 Accepting new patients
Alliance Radiology, PA Past Accepting new patients
Harrison Dialysis LLC PastSince Jan 11, 2021 Accepting new patients
Ozarks Medical Center Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: mselby737726@directb.mercy.net

Organizations & group practices 6

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1225929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688774400000",
    "number": "1346494192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 SKAGGS RD STE 302",
            "city": "BRANSON",
            "state": "MO",
            "postal_code": "656162062",
            "telephone_number": "417-334-8288",
            "fax_number": "417-334-6966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 SKAGGS RD, STE 302",
            "city": "BRANSON",
            "state": "MO",
            "postal_code": "656162062",
            "telephone_number": "417-334-8288",
            "fax_number": "417-334-6966"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1409 Gladden Street",
            "address_purpose": "LOCATION",
            "city": "Harrison",
            "state": "AR",
            "postal_code": "726012236",
            "country_code": "US",
            "telephone_number": "870-204-6683",
            "fax_number": "870-204-6686",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SELBY",
        "first_name": "MICHAEL",
        "middle_name": "GRANT",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-11-06",
        "last_updated": "2023-07-08",
        "certification_date": "2023-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2014008959",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "MO",
            "license": "2014008959",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "212205001",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2000014075",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Branson, MO

Sources for this page

Verify at the official NPI Registry.