Individual provider Active NPI

Helen Selisker, RNP

  • Nurse Practitioner
  • Minneapolis, MN
National Provider Identifier
1487705620
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
R040470 3 Issued in MN
Practice address
2904 Johnson St NE
Minneapolis, MN 55418-2234
Phone
(612) 788-0900
Fax
(612) 788-4930
NPI assigned
Jan 15, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X R040470 3 MN Primary

Addresses

Primary practice location

2904 Johnson St NE
Minneapolis, MN 55418-2234

Mailing address

2904 Johnson St NE
Minneapolis, MN 55418-2234
Phone (612) 788-0900

Other identifiers 5

IdentifierTypeStateIssuer
352742500MedicaidMN
1001229OtherMNPREFERRED ONE
0405614OtherMNMEDICA PRIMARY-SHARE
0405615OtherMNMEDICA
35OJ8SEOtherMNBLUES

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
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R040470 3MNMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1168819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1487705620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2904 JOHNSON ST NE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554182234",
            "telephone_number": "612-788-0900",
            "fax_number": "612-788-4930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2904 JOHNSON ST NE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554182234",
            "telephone_number": "612-788-0900",
            "fax_number": "612-788-4930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SELISKER",
        "first_name": "HELEN",
        "credential": "RNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-15",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MN",
            "license": "R040470 3",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "352742500",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "1001229",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA PRIMARY-SHARE",
            "identifier": "0405614",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "0405615",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUES",
            "identifier": "35OJ8SE",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.