Individual provider Active NPI

Kelly S Selby, R.PH., F.I.A.C.P.

  • Pharmacist
  • Denton, TX
National Provider Identifier
1386785053
Registry record updated Sep 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
25959 Issued in TX
Practice address
4400 Teasley LN
Ste 100
Denton, TX 76210-4650
Phone
(940) 382-1618
Fax
(940) 898-1986
NPI assigned
Feb 8, 2007
Last updated
Sep 2, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 25959 TX Primary

Addresses

Primary practice location

4400 Teasley LN
Ste 100
Denton, TX 76210-4650

Mailing address

4400 Teasley LN
Ste 100
Denton, TX 76210-4650
Phone (940) 382-1618

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)
Not enrolled
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
25959TXMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Community Pharmacy Services Current Accepting new patients
Texas Community Pharmacy Services Current Accepting new patients
Civitas Clinical Services LLC Current Accepting new patients

Locations

4400 Teasley Ln
Ste 100
Denton, TX 76210
Phone (940) 220-5859

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1170892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314921600000",
    "number": "1386785053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4400 TEASLEY LN",
            "address_2": "STE 100",
            "city": "DENTON",
            "state": "TX",
            "postal_code": "762104650",
            "telephone_number": "940-382-1618",
            "fax_number": "940-898-1986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4400 TEASLEY LN",
            "address_2": "STE 100",
            "city": "DENTON",
            "state": "TX",
            "postal_code": "762104650",
            "telephone_number": "940-382-1618",
            "fax_number": "940-898-1986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SELBY",
        "first_name": "KELLY",
        "middle_name": "S",
        "name_prefix": "Mr.",
        "credential": "R.PH., F.I.A.C.P.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-08",
        "last_updated": "2011-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TX",
            "license": "25959",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denton, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2011; 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.