Individual provider Active NPI

Annette Louise Sellon, MSN FNP

  • General Practice Physician
  • Glendale, CA
National Provider Identifier
1639265861
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
402595 Issued in CA
Practice address
3469 N Verdugo Rd
Glendale, CA 91208
Phone
(818) 249-6636
NPI assigned
Oct 5, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 402595 CA Primary

Addresses

Primary practice location

3469 N Verdugo Rd
Glendale, CA 91208

Mailing address

3469 N Verdugo Rd
Glendale, CA 91208
Phone (818) 249-6636

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)
Not enrolled
Credentials
Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
402595CAMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Womens Health Medical Group Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/11541/brand/6/csg/24/fhir/r4

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1639265861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3469 N VERDUGO RD",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "91208",
            "telephone_number": "818-249-6636",
            "fax_number": "818-249-5074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3469 N VERDUGO RD",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "91208",
            "telephone_number": "818-249-6636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SELLON",
        "first_name": "ANNETTE",
        "middle_name": "LOUISE",
        "name_prefix": "Ms.",
        "credential": "MSN FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "402595",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.