Individual provider Active NPI

Douglas E Selover, DO

  • Emergency Medicine Physician
  • Des Moines, IA
National Provider Identifier
1962507277
Registry record updated Jan 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
2782 Issued in IA
Practice address
1111 6TH Ave
Pediatric Emergency Dept
Des Moines, IA 50314-2613
Phone
(515) 247-3211
Fax
(515) 643-8933
NPI assigned
Sep 13, 2006
Last updated
Jan 3, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2014

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 2782 IA Primary
Pediatrics Physician 208000000X 2782 IA
Hospitalist Physician 208M00000X 2782 IA

Addresses

Primary practice location

1111 6TH Ave
Pediatric Emergency Dept
Des Moines, IA 50314-2613

Mailing address

PO Box 4925
Des Moines, IA 50305-4925
Phone (515) 247-3292

Other identifiers 2

IdentifierTypeStateIssuer
4110247MedicaidIA
33642OtherIAWELLMARK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

National Provider Directory

National Provider Directory
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.
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
2782IAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Des Moines River Physicians, LLC Emergency Medicine CurrentSince May 1, 2015 Accepting new patients
Des Moines River Physicians, LLC Emergency Medicine CurrentSince May 1, 2015 Accepting new patients
Des Moines River Physicians, LLC Emergency Medicine Current Accepting new patients
Mercy Medical Center-Newton Past Accepting new patients

Locations

1111 6th Ave
Des Moines, IA 50314
Phone (515) 247-3121

1111 6th Ave
Ste 2
Des Moines, IA 50314
Phone (515) 643-5444

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1388707200000",
    "number": "1962507277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4925",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503054925",
            "telephone_number": "515-247-3292",
            "fax_number": "515-643-8933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 6TH AVE",
            "address_2": "PEDIATRIC EMERGENCY DEPT",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503142613",
            "telephone_number": "515-247-3211",
            "fax_number": "515-643-8933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SELOVER",
        "first_name": "DOUGLAS",
        "middle_name": "E",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-13",
        "last_updated": "2014-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IA",
            "license": "2782",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IA",
            "license": "2782",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IA",
            "license": "2782",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4110247",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK",
            "identifier": "33642",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Moines, IA

Sources for this page

Verify at the official NPI Registry.