John Thomas Selman III, ATC, LAT

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

TCA027 Issued in KY

Practice address

210 Lindsey Wilson St
Columbia, KY 42728-1298

Phone

(270) 384-8070

Fax

(270) 384-8078

NPI assigned

Nov 19, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1637280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637280000000",
    "number": "1700543204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "803 HUGHES ST APT 207",
            "city": "COLUMBIA",
            "state": "KY",
            "postal_code": "427281079",
            "telephone_number": "270-723-4067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 LINDSEY WILSON ST",
            "city": "COLUMBIA",
            "state": "KY",
            "postal_code": "427281298",
            "telephone_number": "270-384-8070",
            "fax_number": "270-384-8078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SELMAN",
        "first_name": "JOHN",
        "middle_name": "THOMAS",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "ATC, LAT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-11-19",
        "last_updated": "2021-11-19",
        "certification_date": "2021-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "KY",
            "license": "TCA027",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "Columbia",
            "affiliation": "N",
            "endpointDescription": "Lindsey Wilson College",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Columbia",
            "address_1": "210 Lindsey Wilson St",
            "city": "Columbia",
            "state": "KY",
            "country_code": "US",
            "postal_code": "427281298",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Athletic Trainer in Columbia, KY
• Providers in Columbia, KY by specialty
• Athletic Trainer in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2021; 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.