NPIMap

Individual provider Active NPI

Brenda A. Sellner, FNP-C

  • Family Nurse Practitioner
  • Lewiston, ID
National Provider Identifier
1720547847
Registry record updated Mar 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
60939 Issued in ID
Practice address
332 Thain Rd
Lewiston, ID 83501-5337
Phone
(208) 220-1652
Fax
(844) 358-8784
NPI assigned
Mar 18, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 18, 2019

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 60939 ID Primary

Addresses

Primary practice location

332 Thain Rd
Lewiston, ID 83501-5337

Mailing address

327 Paradise Rd
Grangeville, ID 83530-5319
Phone (208) 507-0115

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210831000299 TX Practitioner - Nurse Practitioner 6406181882 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nez Perce Tribal Health AuthorityGroup PAC ID 0941288302, 16 clinicians

Practice addresses (Care Compare)

111 Bever Grade Rd
Nimiipuu Health
Lapwai, ID 83540-0367
Phone (208) 621-4946

Hospital & facility affiliations

  • St Mary'S Hospital Hospital, Cottonwood, ID, CCN 131321
  • Clearwater Valley Hospital & Clinics Hospital, Orofino, ID, CCN 131320
  • Tri-State Memorial Hospital Hospital, Clarkston, WA, CCN 501332

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
60939IDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Nez Perce Tribal Health Authority CurrentSince May 12, 2021 Accepting new patients

Locations

313 3Rd St
Nimiipuu Health
Kamiah, ID 83536
Phone (208) 621-4946

313 3Rd St
Nimiipuu Health
Kamiah, ID 83536
Phone (208) 935-0733

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 and National Provider Directory roles.

Hospital & facility affiliations 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1552867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552867200000",
    "number": "1720547847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "327 PARADISE RD",
            "city": "GRANGEVILLE",
            "state": "ID",
            "postal_code": "835305319",
            "telephone_number": "208-507-0115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "332 THAIN RD",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835015337",
            "telephone_number": "208-220-1652",
            "fax_number": "844-358-8784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SELLNER",
        "first_name": "BRENDA",
        "middle_name": "A.",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-18",
        "last_updated": "2019-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ID",
            "license": "60939",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewiston, ID

Sources for this page

Verify at the official NPI Registry.