William John Self, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

9475918-4405 Issued in UT

Practice address

6222 S Moffat Farm LN
Salt Lake City, UT 84121-6713

Phone

(970) 590-3773

NPI assigned

Aug 23, 2018

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/13794/brand/1/csg/1/fhir/r4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Maliheh Free Clinic

  • Primary Care Clinic/Center
  • Millcreek, UT
  • NPI 1215823497
  NPD (past)

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

{
    "created_epoch": "1534982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548115200000",
    "number": "1346721891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6222 S MOFFAT FARM LN",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841216713",
            "telephone_number": "970-590-3776",
            "fax_number": "801-290-2466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6222 S MOFFAT FARM LN",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841216713",
            "telephone_number": "970-590-3773"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1950 E 7000 S",
            "address_purpose": "LOCATION",
            "city": "Salt Lake City",
            "state": "UT",
            "postal_code": "841216894",
            "country_code": "US",
            "telephone_number": "801-943-3300",
            "fax_number": "801-943-3461",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1840 S 1300 E",
            "address_purpose": "LOCATION",
            "city": "Salt Lake City",
            "state": "UT",
            "postal_code": "841053617",
            "country_code": "US",
            "telephone_number": "801-484-7651",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "941 E 3300 S",
            "address_purpose": "LOCATION",
            "city": "Millcreek",
            "state": "UT",
            "postal_code": "841062100",
            "country_code": "US",
            "telephone_number": "801-266-3700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SELF",
        "first_name": "WILLIAM",
        "middle_name": "JOHN",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-08-23",
        "last_updated": "2019-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "UT",
            "license": "9475918-3102",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "9475918-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nikkia Seiuli
• Mehtab Kaur Sekhon, MD
• Selina Sekulic, D.P.M
• Andy Sekutowski
• Selarom Surgical Center, LLC
• William J Selfridge Jr., LCSW
• Sheryl Anne Seliger, LCSW
• Steven G. Seliger, LMFT
• Motaz Selim, M.D.
• Floralie Beliard Selin, ADULT CARE WORKER

• Family Nurse Practitioner in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Family Nurse Practitioner in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2019; 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.