Active NPI
Selena Ellis, RN
- Registered Nurse
- Clermont, FL
National Provider Identifier
1821794884
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- RN9300293
- Practice address
- 1909 Knollcrest Dr
Clermont, FL 34711-5115 - Phone
- (352) 531-4624
- NPI assigned
- Feb 1, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | RN9300293 | FL | Primary |
Addresses
Primary practice location
1909 Knollcrest Dr
Clermont, FL 34711-5115
Mailing address
1909 Knollcrest Dr
Clermont, FL 34711-5115
Phone (352) 531-4624
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN9300293 | FL | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1675209600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1675209600000",
"number": "1821794884",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1909 KNOLLCREST DR",
"city": "CLERMONT",
"state": "FL",
"postal_code": "347115115",
"telephone_number": "352-531-4624"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1909 KNOLLCREST DR",
"city": "CLERMONT",
"state": "FL",
"postal_code": "347115115",
"telephone_number": "352-531-4624"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELLIS",
"first_name": "SELENA",
"credential": "RN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-02-01",
"last_updated": "2023-02-01",
"certification_date": "2023-02-01",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "FL",
"license": "RN9300293",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clermont, FL
- Elite Supply & Services, LLC (Breathe Easy Rideshare, CleanAir Medical Couriers, Sparkling Cleaning)
- Jessica Elkareh, LMFT
- David L Ellens, MD
- Andrea Elliott, BCABA
- Gillian A Ellis, MD
- Shea Ellis, RBT
- Lindsay Patricia Elworthy, CF-SLP
- Emergency Physicians of Central Florida, LLP
- Emergency Physicians of Central Florida, LLP
- Lauren Hood Emrick, APRN, DNP, NP-C
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.