Selma Ali Yallah, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

RN204157 Issued in GA

Practice address

1277 Wellbrook Cir NE Ste C
Conyers, GA 30012-3973

Phone

(770) 679-5453

Fax

(770) 679-5457

NPI assigned

Jun 27, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Conyers Psychiatry LLC

  • Psychiatry Physician
  • Conyers, GA
  • NPI 1457059628
  Medicare reassignment NPD

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

{
    "created_epoch": "1561593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612224000000",
    "number": "1831750975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1277 WELLBROOK CIR NE STE C",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300123973",
            "telephone_number": "770-679-5453",
            "fax_number": "770-679-5457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1277 WELLBROOK CIR NE STE C",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300123973",
            "telephone_number": "770-679-5453",
            "fax_number": "770-679-5457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YALLAH",
        "first_name": "SELMA",
        "middle_name": "ALI",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-06-27",
        "last_updated": "2021-02-02",
        "certification_date": "2021-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "GA",
            "license": "RN204157",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Conyers",
            "affiliation": "N",
            "address_1": "1277 Wellbrook Cir NE Ste C",
            "city": "Conyers",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300123973",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Denise Deborah Young-Smith, CNA
• Bradley Young, PHARM.D.
• Erika Young, LPC

• Psychiatric/Mental Health Nurse Practitioner in Conyers, GA
• Providers in Conyers, GA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.