Individual provider Active NPI

Selina Lorraine Graham-Moline, OTR-L, OTD

  • Gerontology Occupational Therapist
  • Irving, TX
National Provider Identifier
1629951827
Registry record updated Apr 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Occupational TherapistTaxonomy code 225XG0600X
License
122691 Issued in TX
Practice address
1295 Kinwest Pkwy
Irving, TX 75063-3560
Phone
(954) 304-1887
NPI assigned
Jul 28, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 15, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Occupational TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225XG0600X 122691 TX Primary

Addresses

Primary practice location

1295 Kinwest Pkwy
Irving, TX 75063-3560

Mailing address

1295 Kinwest Pkwy
Irving, TX 75063-3560
Phone (469) 351-2280

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250916002152 TX Practitioner - Occupational Therapist in Private Practice 6002310828 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Legacy Healthcare Services IncGroup PAC ID 2163339722, 3,431 clinicians

Practice addresses (Care Compare)

1295 Kinwest Pkwy
Irving, TX 75063-3560
Phone (469) 317-7621

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Healthcare Services Inc. CurrentSince Aug 25, 2025 Accepting new patients
Legacy Healthcare Services Inc CurrentSince Aug 25, 2025 Accepting new patients

Locations

110 Horizon Dr
#310
Raleigh, NC 27615

110 Horizon Dr
Ste 310
Raleigh, NC 27615
Phone (970) 215-3300

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": "1753660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776211200000",
    "number": "1629951827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1295 KINWEST PKWY",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750633560",
            "telephone_number": "469-351-2280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1295 KINWEST PKWY",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750633560",
            "telephone_number": "954-304-1887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAHAM-MOLINE",
        "first_name": "SELINA",
        "middle_name": "LORRAINE",
        "name_prefix": "Mrs.",
        "credential": "OTR-L, OTD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-07-28",
        "last_updated": "2026-04-15",
        "certification_date": "2026-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XG0600X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist, Gerontology",
            "state": "TX",
            "license": "122691",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irving, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.