NPIMap

Organization Active NPI

Selby General Hospital

  • Rural Health Clinic/Center
  • Waterford, OH
National Provider Identifier
1750180162
Registry record updated Mar 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
SELBY GENERAL HOSPITAL
Practice address
151 Anderson LN
Waterford, OH 45786-5312
Phone
(740) 984-2332
Fax
(740) 984-4435
NPI assigned
Mar 10, 2025
Organization subpart
Yes
Parent organization
SELBY GENERAL HOSPITALAs reported in NPPES

Authorized official

NPPES NPI Registry
Name
Paul G Westbrock
Title
VP Legal Affairs
Phone
(740) 374-1581

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Other NPIs on the same Medicare enrollment 9

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
36D0351164Selby General Hospital151 Anderson Lane, Waterford, OH 45786Certificate of waiverApr 10, 2028

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040108000165 OH Part B Supplier - Clinic/Group Practice 9638087893 Receives reassigned benefits from 109 practitioners
12 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Athens, OH; Waterford, OH; Vincent, OH; Marietta, OH; Logan, OH; Caldwell, OH

National Provider Directory

National Provider Directory
Tax ID family
Selby Family Care7 organizations share this tax ID, including this one
Part of
Selby Family Care

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Locations

40 White Oak Professional Ctr
Vincent, OH 45784
Phone (740) 678-2374

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary

Addresses

NPPES NPI Registry

Primary practice location

151 Anderson LN
Waterford, OH 45786-5312

Mailing address

401 Matthew St
Marietta, OH 45750-1635

Other names 1

NPPES NPI Registry
  • Dept of Primary Care Waterford Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 10, 2025.

{
    "created_epoch": "1741564800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741564800000",
    "number": "1750180162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 MATTHEW ST",
            "city": "MARIETTA",
            "state": "OH",
            "postal_code": "457501635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 ANDERSON LN",
            "city": "WATERFORD",
            "state": "OH",
            "postal_code": "457865312",
            "telephone_number": "740-984-2332",
            "fax_number": "740-984-4435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SELBY GENERAL HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SELBY GENERAL HOSPITAL",
        "enumeration_date": "2025-03-10",
        "last_updated": "2025-03-10",
        "certification_date": "2025-03-10",
        "status": "A",
        "authorized_official_last_name": "WESTBROCK",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "VP LEGAL AFFAIRS",
        "authorized_official_telephone_number": "740-374-1581"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dept of Primary Care Waterford",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Waterford, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.