Individual provider Active NPI

Raymond Clifford Selden, PA-C

  • Physician Assistant
  • Winston Salem, NC
National Provider Identifier
1780558429
Registry record updated Oct 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-15870 Issued in NC
Practice address
1255 Creekshire Way Ste 290
Winston Salem, NC 27103-3061
Phone
(833) 701-3111
NPI assigned
Oct 4, 2025
Last updated
Oct 4, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0010-15870 NC Primary

Addresses

Primary practice location

1255 Creekshire Way Ste 290
Winston Salem, NC 27103-3061

Mailing address

1255 Creekshire Way Ste 290
Winston Salem, NC 27103-3061

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20260217002905 NC Practitioner - Physician Assistant 4789164898 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Duke University School of Medicine, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Certus Psychiatry and Integrated Care PLLCGroup PAC ID 0244506756, 17 clinicians

Practice addresses (Care Compare)

1255 Creekshire Way
Suite 270
Winston Salem, NC 27103-3061
Phone (336) 701-3111

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0010-15870NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Certus Psychiatry and Integrated Care PLLC CurrentSince Feb 6, 2026 Accepting new patients

Locations

1255 Creekshire Way
Ste 270
Winston Salem, NC 27103
Phone (336) 701-3111

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1759536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759536000000",
    "number": "1780558429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1255 CREEKSHIRE WAY STE 290",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271033061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1255 CREEKSHIRE WAY STE 290",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271033061",
            "telephone_number": "833-701-3111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SELDEN",
        "first_name": "RAYMOND",
        "middle_name": "CLIFFORD",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-10-04",
        "last_updated": "2025-10-04",
        "certification_date": "2025-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-15870",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

Verify at the official NPI Registry.