Individual provider Active NPI

Mandy Selders

  • Nurse Practitioner
  • Chambersburg, PA
National Provider Identifier
1992347454
Registry record updated Jan 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
SP021214 Issued in PA
Practice address
50 Black Ave
Chambersburg, PA 17201-2115
Phone
(717) 262-4969
NPI assigned
Oct 16, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN556921 PA
Nurse Practitioner 363L00000X SP021214 PA Primary

Addresses

Primary practice location

50 Black Ave
Chambersburg, PA 17201-2115

Mailing address

200 N 7TH St
Lebanon, PA 17046-5040

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200205002379 PA Practitioner - Nurse Practitioner 0345676680 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Pennsylvania Counseling Services, Inc.Group PAC ID 1355331471, 55 clinicians

Practice addresses (Care Compare)

200 N 7TH St
Lebanon, PA 17046-5040
Phone (717) 272-1653

75 S Main St
Chambersburg, PA 17201-2224
Phone (717) 262-4969

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN556921PAMDRegistered Nurse
SP021214PAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pennsylvania Counseling Services Inc. CurrentSince Dec 24, 2019 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

334 York St
Gettysburg, PA 17325
Phone (717) 337-0026

200 N 7th St
Lebanon, PA 17046
Phone (717) 272-5464

Organizations & group practices 2

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": "1571184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579824000000",
    "number": "1992347454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 N 7TH ST",
            "city": "LEBANON",
            "state": "PA",
            "postal_code": "170465040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 BLACK AVE",
            "city": "CHAMBERSBURG",
            "state": "PA",
            "postal_code": "172012115",
            "telephone_number": "717-262-4969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SELDERS",
        "first_name": "MANDY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-16",
        "last_updated": "2020-01-24",
        "certification_date": "2020-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "PA",
            "license": "RN556921",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP021214",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chambersburg, PA

Sources for this page

Verify at the official NPI Registry.