Individual provider Active NPI

Trevor M Selvage, RD, LD

  • Registered Dietitian
  • Orlando, FL
National Provider Identifier
1457050031
Registry record updated Feb 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
ND10260 Issued in FL
Practice address
60 W Gore St FL
2ND Floor Mp127
Orlando, FL 32806-1141
Phone
(321) 843-7976
Fax
(321) 843-6870
NPI assigned
Mar 2, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X ND10260 FL Primary

Addresses

Primary practice location

60 W Gore St FL
2ND Floor Mp127
Orlando, FL 32806-1141

Mailing address

60 W Gore St FL 2
Orlando, FL 32806-1141
Phone (321) 843-7976

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

NPI Registry JSON

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

{
    "created_epoch": "1677715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707436800000",
    "number": "1457050031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 W GORE ST FL 2",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328061141",
            "telephone_number": "321-843-7976",
            "fax_number": "321-843-6870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 W GORE ST FL",
            "address_2": "2ND FLOOR MP127",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328061141",
            "telephone_number": "321-843-7976",
            "fax_number": "321-843-6870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SELVAGE",
        "first_name": "TREVOR",
        "middle_name": "M",
        "credential": "RD, LD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-03-02",
        "last_updated": "2024-02-09",
        "certification_date": "2024-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "FL",
            "license": "ND10260",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2024; 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.