Individual provider Active NPI

Kera Rose Selzer, NP-C

  • Family Nurse Practitioner
  • Dallas, NC
National Provider Identifier
1811324049
Registry record updated Mar 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5007062 Issued in NC
Practice address
600 W Trade St Ste a
Dallas, NC 28034-1543
Phone
(980) 834-9130
Fax
(980) 834-9869
NPI assigned
Oct 2, 2013
Last updated
Mar 12, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 18504 SC
Family Nurse Practitioner 363LF0000X 5007062 NC Primary

Addresses

Primary practice location

600 W Trade St Ste a
Dallas, NC 28034-1543

Mailing address

PO Box 744786
Atlanta, GA 30374-4786
Phone (704) 834-2450

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
I20141010002297 NC Practitioner - Nurse Practitioner 5799913182 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Caromont Medical Group IncGroup PAC ID 3577476258, 425 clinicians

Practice addresses (Care Compare)

600 W Trade St
Suite a
Dallas, NC 28034-1543
Phone (704) 834-2450

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Caromont Medical Group, Inc. CurrentSince Jul 23, 2018 Accepting new patients
Caromont Medical Group Inc Current Accepting new patients
Caromont Medical Group Inc CurrentSince Jul 23, 2018 Accepting new patients

Locations

1220 Spruce St
Belmont, NC 28012
Phone (704) 263-0300

600 W Trade St
Dallas, NC 28034
Phone (980) 834-9130

600 W Trade St
Ste A
Dallas, NC 28034
Phone (980) 834-9130

2240 Remount Rd
Gastonia, NC 28054
Phone (704) 671-5311

2525 Court Dr
Gastonia, NC 28054
Phone (704) 834-2662

660 Summit Crossing Pl
Ste 301
Gastonia, NC 28054
Phone (704) 854-8799

Organizations & group practices 3

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1380672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583971200000",
    "number": "1811324049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 744786",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303744786",
            "telephone_number": "704-834-2450",
            "fax_number": "704-671-5331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 W TRADE ST STE A",
            "city": "DALLAS",
            "state": "NC",
            "postal_code": "280341543",
            "telephone_number": "980-834-9130",
            "fax_number": "980-834-9869"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SELZER",
        "first_name": "KERA",
        "middle_name": "ROSE",
        "name_prefix": "Mrs.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-10-02",
        "last_updated": "2020-03-12",
        "certification_date": "2020-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "18504",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5007062",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, NC

Sources for this page

Verify at the official NPI Registry.