NPIMap

Individual provider Active NPI

Selena Jeanette Ankarberg, FNP

  • Nurse Practitioner
  • Weiser, ID
National Provider Identifier
1497840292
Registry record updated Jul 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
NP-730A Issued in ID
Practice address
683 E 3Rd St
Weiser, ID 83672-2248
Phone
(208) 549-0211
Fax
(208) 549-0104
NPI assigned
Oct 4, 2006
Last updated
Jul 15, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2008

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 NP-730A ID Primary

Addresses

Primary practice location

683 E 3Rd St
Weiser, ID 83672-2248

Mailing address

PO Box 871
Weiser, ID 83672-0871
Phone (208) 549-0211

Other identifiers 1

IdentifierTypeStateIssuer
807397200MedicaidID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060502000776 ID Practitioner - Nurse Practitioner 5597775759 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Weiser Valley Hospital DistrictGroup PAC ID 5294704276, 60 clinicians
Cascade Medical Center Hospital DistrictGroup PAC ID 6103739719, shared by 3 NPIs, 13 clinicians

Practice addresses (Care Compare)

360 E Liberty St
Weiser, ID 83672-2261

402 Lake Cascade Pkwy
Cascade, ID 83611-7702
Phone (208) 382-4285

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Weiser Valley Hospital District CurrentSince Jan 24, 2023 Accepting new patients
Two Rivers Medical Clinic, PA CurrentSince Jan 1, 2006 Accepting new patients
Weiser Valley Hospital District CurrentSince Jan 24, 2023 Accepting new patients
Weiser Valley Hospital District Past Accepting new patients

Locations

360 E Liberty St
Weiser, ID 83672
Phone (208) 414-1124

360 E Liberty St
#A
Weiser, ID 83672
Phone (208) 549-4424

360 E Liberty St
#B
Weiser, ID 83672
Phone (208) 549-4424

645 E 5th St
Weiser, ID 83672
Phone (208) 549-0370

683 E 3rd St
Weiser, ID 83672
Phone (208) 549-0211

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 4

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.

Hospital & facility affiliations 11

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216080000000",
    "number": "1497840292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 871",
            "city": "WEISER",
            "state": "ID",
            "postal_code": "836720871",
            "telephone_number": "208-549-0211",
            "fax_number": "208-549-0104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "683 E 3RD ST",
            "city": "WEISER",
            "state": "ID",
            "postal_code": "836722248",
            "telephone_number": "208-549-0211",
            "fax_number": "208-549-0104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANKARBERG",
        "first_name": "SELENA",
        "middle_name": "JEANETTE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-04",
        "last_updated": "2008-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "ID",
            "license": "NP-730A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "807397200",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Weiser, ID

Sources for this page

Verify at the official NPI Registry.