Individual provider Active NPI

Elaine Marie Harlan Selden, NP-C

  • Family Nurse Practitioner
  • Des Moines, IA
National Provider Identifier
1669403010
Registry record updated Nov 3, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
A058855 Issued in IA
Practice address
8131 University Blvd
Des Moines, IA 50325-1123
Phone
(515) 225-8180
Fax
(515) 225-2041
NPI assigned
Jul 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X A058855 IA Primary

Addresses

Primary practice location

8131 University Blvd
Des Moines, IA 50325-1123

Mailing address

8131 University Blvd
Des Moines, IA 50325-1123
Phone (515) 225-8180

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20060412000059 IA Practitioner - Nurse Practitioner 4880603315 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A058855IAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Soderstrom Dermatology Center S C CurrentSince May 20, 2022 Accepting new patients
Soderstrom Dermatology Center S C CurrentSince May 20, 2022 Accepting new patients

Locations

1800 E 54th St
Ste B
Davenport, IA 52807
Phone (563) 242-3571

8131 University Blvd
Des Moines, IA 50325
Phone (515) 225-8180

4909 N Glen Park Place Rd
Peoria, IL 61614
Phone (309) 674-7546

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": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1288742400000",
    "number": "1669403010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8131 UNIVERSITY BLVD",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503251123",
            "telephone_number": "515-225-8180",
            "fax_number": "515-225-2041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8131 UNIVERSITY BLVD",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503251123",
            "telephone_number": "515-225-8180",
            "fax_number": "515-225-2041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SELDEN",
        "first_name": "ELAINE",
        "middle_name": "MARIE HARLAN",
        "name_prefix": "Mrs.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-05",
        "last_updated": "2010-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IA",
            "license": "A058855",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Moines, IA

Sources for this page

Verify at the official NPI Registry.