William Scott Selvidge, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

038-008622 Issued in IL

Practice address

608 Broadway Ave
Mattoon, IL 61938-4321

Phone

(217) 235-4664

Fax

(217) 235-2100

NPI assigned

Jan 4, 2007

Last updated

Aug 19, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

Practice roles

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.

• Selvidge Chiropractic

  • Chiropractor
  • Mattoon, IL
  • NPI 1346790342
  NPD (past) Authorized official
• Selvidge Chiropractic PC

  • Chiropractor
  • Mattoon, IL
  • NPI 1205027364
  NPD (past)

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

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660867200000",
    "number": "1841347812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "608 BROADWAY AVE",
            "city": "MATTOON",
            "state": "IL",
            "postal_code": "619384321",
            "telephone_number": "217-235-4664",
            "fax_number": "217-235-2100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "608 BROADWAY AVE",
            "city": "MATTOON",
            "state": "IL",
            "postal_code": "619384321",
            "telephone_number": "217-235-4664",
            "fax_number": "217-235-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SELVIDGE",
        "first_name": "WILLIAM",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-04",
        "last_updated": "2022-08-19",
        "certification_date": "2022-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038-008622",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF IL",
            "identifier": "06022634",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "407016",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "038008622",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "44-03304",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRIVATE HEALTHCARE SYSTEM",
            "identifier": "9086460",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maja Seitz
• Selvidge Chiropractic
• Selvidge Chiropractic PC
• Donald R. Selvidge, D.C.
• Nancy C. Selvidge, D.C.
• Koyeli Sengupta
• Amanita Setari
• Sydney L Shackelford, FNP
• Kristy Dawn Shafer, NP
• Robin Shafer

• Chiropractor in Mattoon, IL
• Providers in Mattoon, IL by specialty
• Chiropractor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.