Individual provider Active NPI

John A Selling, MD

  • Gastroenterology Physician
  • Portola Valley, CA
National Provider Identifier
1386608024
Registry record updated Jan 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
G46375 Issued in CA
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

Updated by the provider on Jan 21, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
MMM00087MOtherNHIC

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

LicenseStateTypeSpecialty
G046375CAMDGastroenterology Physician
G46375CAMDGastroenterology 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.

Verify at the official NPI Registry.