Individual provider Active NPI

Selyna Belle McGeown, RD, CDCES

  • Registered Dietitian
  • Santa Ana, CA
National Provider Identifier
1851908321
Registry record updated May 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
86116207 Issued in CA
Practice address
2212 E 4TH St Ste 301
Santa Ana, CA 92705-3873
Phone
(714) 628-3242
NPI assigned
Sep 28, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 3, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 86116207 CA Primary

Addresses

Primary practice location

2212 E 4TH St Ste 301
Santa Ana, CA 92705-3873

Mailing address

2212 E 4TH St Ste 301
Santa Ana, CA 92705-3873
Phone (714) 628-3242

Other names 1

  • Selyna Belle Jacobs Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220718001143 CA Practitioner - Registered Dietitian Or Nutrition Professional 9638550080 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Providence Medical FoundationGroup PAC ID 8921993205, 1,461 clinicians

Practice addresses (Care Compare)

1950 Sunny Crest Dr
Suite 2900
Fullerton, CA 92835-3641
Phone (714) 992-5350

26800 Crown Valley Pkwy
Suite 435
Mission Viejo, CA 92691-8023
Phone (949) 542-8007

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
86116207CAMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Medical Foundation CurrentSince May 2, 2022 Accepting new patients
The J. Moss Foundation Dietitian, Registered CurrentSince Jan 22, 2023 Accepting new patients
Providence Medical Foundation Current Accepting new patients
Providence Medical Foundation CurrentSince May 2, 2022 Accepting new patients
Wecare Pharmaceutical Services Inc PastSince Oct 1, 2020 Accepting new patients
Providence Medical Foundation Past Accepting new patients

Locations

200 W Ctr St Promenade
Ste 300
Anaheim, CA 92805
Phone (714) 449-4841

100 E Valencia Mesa Dr
Ste 105
Fullerton, CA 92835
Phone (714) 446-5200

1950 Sunny Crest Dr
Ste 2900
Fullerton, CA 92835

2212 E 4th St
Santa Ana, CA 92705
Phone (714) 288-3230

2212 E 4th St
Ste 301
Santa Ana, CA 92705
Phone (714) 288-3230

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1601251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651536000000",
    "number": "1851908321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2212 E 4TH ST STE 301",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927053873",
            "telephone_number": "714-628-3242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2212 E 4TH ST STE 301",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927053873",
            "telephone_number": "714-628-3242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGEOWN",
        "first_name": "SELYNA",
        "middle_name": "BELLE",
        "credential": "RD, CDCES",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-09-28",
        "last_updated": "2022-05-03",
        "certification_date": "2022-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "CA",
            "license": "86116207",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SELYNA",
            "last_name": "JACOBS",
            "middle_name": "BELLE",
            "credential": "RD,CDCES",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Santa Ana, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.