Active NPI
John A Selling, MD
- Gastroenterology Physician
- Portola Valley, CA
National Provider Identifier
1386608024
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- G46375
- Practice address
- 340 Willowbrook Dr
Portola Valley, CA 94028-7842 - Phone
- (650) 743-0932
- NPI assigned
- Apr 12, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gastroenterology Physician | 207RG0100X | G046375 | CA | |
| Gastroenterology Physician | 207RG0100X | G46375 | CA | Primary |
Addresses
Primary practice location
340 Willowbrook Dr
Portola Valley, CA 94028-7842
Mailing address
340 Willowbrook Dr
Portola Valley, CA 94028-7842
Phone (650) 743-0932
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| MMM00087M | Other | NHIC |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G046375 | CA | MD | Gastroenterology Physician |
| G46375 | CA | MD | Gastroenterology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144800000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1579564800000",
"number": "1386608024",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "340 WILLOWBROOK DR",
"city": "PORTOLA VALLEY",
"state": "CA",
"postal_code": "940287842",
"telephone_number": "650-743-0932"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "340 WILLOWBROOK DR",
"city": "PORTOLA VALLEY",
"state": "CA",
"postal_code": "940287842",
"telephone_number": "650-743-0932"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SELLING",
"first_name": "JOHN",
"middle_name": "A",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-04-12",
"last_updated": "2020-01-21",
"certification_date": "2020-01-21",
"status": "A"
},
"taxonomies": [
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "CA",
"license": "G046375",
"primary": false
},
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "CA",
"license": "G46375",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NHIC",
"identifier": "MMM00087M",
"state": null
}
],
"endpoints": [],
"other_names": []
}
Other providers in Portola Valley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.