Selina Harrison, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

LPN073776 Issued in GA

Practice address

5617 Princeton Ave Ste B
Columbus, GA 31904-3483

Phone

(706) 257-7722

NPI assigned

Nov 22, 2021

Sex

Female

Sole proprietor

No

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

Practice roles

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.

• Columbus Addiction Associates, LLC

  dba MedMark Treatment Centers Columbus North

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Columbus, GA
  • NPI 1700244415
  NPD (past)

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

{
    "created_epoch": "1637539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637539200000",
    "number": "1710644992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9493",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319089493",
            "telephone_number": "706-326-7986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5617 PRINCETON AVE STE B",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319043483",
            "telephone_number": "706-257-7722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRISON",
        "first_name": "SELINA",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-22",
        "last_updated": "2021-11-22",
        "certification_date": "2021-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "GA",
            "license": "LPN073776",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "selinaharrison@medmark.com",
            "affiliation": "N",
            "endpointDescription": "email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "5617 Princeton Ave Ste B",
            "city": "Columbus",
            "state": "GA",
            "country_code": "US",
            "postal_code": "319043483",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Takiviauna R Harris
• Ben A. Harrison, HAD
• Danitra Harrison
• Gregory Harrison
• Ordress Sherita Harrison
• Shelli Nicole Harrison
• Toshia Harrison
• Shameah Harriss, RBT
• Amber Harrow
• Erika Harrow

• Licensed Practical Nurse in Columbus, GA
• Providers in Columbus, GA by specialty
• Licensed Practical Nurse in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 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.