Individual provider Active NPI

Cassandra Dawn Selby, RN, BSN, CNM, ARNP

  • Advanced Practice Midwife
  • Lafayette, IN
National Provider Identifier
1639320641
Registry record updated Jul 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
09000357A Issued in IN
Practice address
2316 South St
Lafayette, IN 47904-2971
Phone
(765) 742-1567
Fax
(765) 429-2700
NPI assigned
Oct 8, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X 09000357A IN Primary

Addresses

Primary practice location

2316 South St
Lafayette, IN 47904-2971

Mailing address

1716 Hartford St
Lafayette, IN 47904-2138
Phone (765) 742-1567

Other identifiers 1

IdentifierTypeStateIssuer
300045852MedicaidIN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201119003182 IN Practitioner - Certified Nurse Midwife (CNM) 5193912202 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Nurse Midwife (CNM)
Education
Oregon Health Sciences University School of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Riggs Community Health Center IncGroup PAC ID 2365432226, 23 clinicians

Practice addresses (Care Compare)

1324 Tippecanoe St
Lafayette, IN 47904-2051
Phone (765) 742-1567

1716 Hartford St
Lafayette, IN 47904-2168

1716 Hartford St
Lafayette, IN 47904-2173
Phone 76574215673041

2316 S St
Lafayette, IN 47904-2971
Phone (765) 742-1567

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor on Science - Nursing, Certified Nurse Midwife, Master of Science, Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Riggs Community Health Center Inc Past Accepting new patients
Boone County Community Health Clinic, Inc PastSince Sep 2, 2014 Accepting new patients
Poudre Valley Medical Group, LLC Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1223424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722211200000",
    "number": "1639320641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1716 HARTFORD ST",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479042138",
            "telephone_number": "765-742-1567",
            "fax_number": "765-429-2700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2316 SOUTH ST",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479042971",
            "telephone_number": "765-742-1567",
            "fax_number": "765-429-2700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SELBY",
        "first_name": "CASSANDRA",
        "middle_name": "DAWN",
        "credential": "RN, BSN, CNM, ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-08",
        "last_updated": "2024-07-29",
        "certification_date": "2024-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "IN",
            "license": "09000357A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300045852",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, IN

Sources for this page

Verify at the official NPI Registry.