Individual provider Active NPI

Selina Dina Nanna, PNP

  • Pediatric Nurse Practitioner
  • San Antonio, TX
National Provider Identifier
1588090849
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
765018 Issued in TX
Practice address
8606 Village Dr
San Antonio, TX 78217-5506
Phone
(210) 657-0220
Fax
(210) 590-7288
NPI assigned
Sep 18, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 765018 TX Primary

Addresses

Primary practice location

8606 Village Dr
San Antonio, TX 78217-5506

Mailing address

8606 Village Dr Ste a
San Antonio, TX 78217-5506
Phone (210) 657-0220

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171030000507 TX Practitioner - Nurse Practitioner 8820364334 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Synergy Healthcare Associates, PLLC Pediatrics CurrentSince Jul 18, 2017 Accepting new patients
Northeast Pediatric Associates PA Pediatrics PastSince Jul 24, 2022 Accepting new patients

Locations

14100 San Pedro Ave
Ste 200
San Antonio, TX 78232

300 E Sonterra Blvd
Ste 320
San Antonio, TX 78258
Phone (210) 619-2710

1139 E Sonterra Blvd
#205
San Antonio, TX 78258
Phone (210) 614-2229

8606 Village Dr
#A
San Antonio, TX 78217
Phone (210) 657-0220

8606 Village Dr
San Antonio, TX 78217
Phone (210) 488-6405

1139 E Sonterra Blvd
Ste 205
San Antonio, TX 78258
Phone (210) 614-2229

5000 Schertz Pkwy
Ste 202
Schertz, TX 78154
Phone (210) 651-1055

Interoperability endpoints

  • Direct secure messaging: selina@npa.pcc-direct.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1379462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1588090849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8606 VILLAGE DR STE A",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782175506",
            "telephone_number": "210-657-0220",
            "fax_number": "210-590-7288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8606 VILLAGE DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782175506",
            "telephone_number": "210-657-0220",
            "fax_number": "210-590-7288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NANNA",
        "first_name": "SELINA",
        "middle_name": "DINA",
        "credential": "PNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-18",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "765018",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.