SELINA A JEANISE (NPI# 1679885644) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679885644 |
| Entity Type | Individual |
| Full Name | SELINA A JEANISE |
| Credential | DO |
| Practice Address |
1333 S Sam Houston Blvd Houston MO 65483-2046 |
| Mailing Address |
12496 Bell Rd Roby MO 65557-8705 |
| Practice Telephone | 4179675435 |
| Mailing Telephone | 9366769575 |
| Enumeration Date | 2010-07-07 |
| Last Update Date | 2019-05-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | 2015040163 | MO | Allopathic & Osteopathic Physicians |
| N | 207P00000X | Emergency Medicine | 0102203214 | VA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GME | 390200000X | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 5325 Faraon St, Saint Joseph, MO 645063488 | 8162716122 | 8162716019 |
| 4430 Missouri Ave, Fort Leonard Wood, MO 65473 | 5735960456 |
| Street Address |
1333 S SAM HOUSTON BLVD |
| City | HOUSTON |
| State | MO |
| Zip Code | 65483-2046 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578548517 | Qasim Mustafa Bajwa | Radiology | 1333 S Sam Houston Blvd, Dept of Radiology, Houston, MO 65483-2046 | 2005-12-13 |
| 1487994208 | Tracey A Arwood | Advanced Practice Midwife | 1333 S Sam Houston Blvd, Houston, MO 65483-2046 | 2013-02-15 |
| 1326246000 | Texas County Memorial Hospital | Clinic/Center | 1333 S Sam Houston Blvd, Houston, MO 65483-2046 | 2007-07-05 |
| 1679637185 | Brett L Welden | Nurse Practitioner | 1333 S Sam Houston Blvd, Houston, MO 65483-2046 | 2006-12-20 |
| 1356402226 | Texas County Memorial Hospital | General Acute Care Hospital | 1333 S Sam Houston Blvd, Houston, MO 65483-2046 | 2006-12-13 |
| 1881755759 | Texas County Memorial Hospital | General Acute Care Hospital | 1333 S Sam Houston Blvd, Houston, MO 65483-2046 | 2006-12-13 |
| 1255492658 | Larry Wayne Ladd | Nurse Anesthetist, Certified Registered | 1333 S Sam Houston Blvd, Texas Co Memorial Hospital, Houston, MO 65483 | 2006-12-12 |
| 1023179298 | Texas County Memorial Hospital | Medicare Defined Swing Bed Unit | 1333 S Sam Houston Blvd, Houston, MO 65483-2046 | 2006-12-12 |
| 1942244165 | Oren K Broughton | Emergency Medicine | 1333 S Sam Houston Blvd, Houston, MO 65483-2046 | 2006-06-16 |
| 1710926928 | Texas County Memorial Hospital | Clinic/Center | 1333 S Sam Houston Blvd, Suite C, Houston, MO 65483-2046 | 2006-06-05 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164921300 | Texas County Memorial Hospital | Clinic/Center | 1333 S Sam Houston Blvd Ste A, Houston, MO 65483 | 2018-02-02 |
| 1942657606 | Community Counseling Services of Missouri, L.L.C. | Counselor | 1591 C North Highway 63, Houston, MO 65483 | 2016-05-23 |
| 1083081681 | Vicky Birdsong | Registered Nurse | 1597 North Hwy 63, Houston, MO 65483 | 2015-08-31 |
| 1578794525 | Mary Jane Lybyer | Speech-Language Pathologist | 423 W. Pine, Houston, MO 65483 | 2009-08-06 |
| 1851530257 | Womack Chiropractic Center, PC | Chiropractor | 118 W. Main St., Houston, MO 65483 | 2009-02-10 |
| 1588793459 | Houston R-1 School District | Local Education Agency (LEA) | 204 W. Spruce, Houston, MO 65483 | 2007-03-05 |
| 1487783296 | Mercy Clinic-springfield Communities | Family Medicine | 1422 S Sam Houston Blvd, Houston, MO 65483 | 2007-03-05 |
| 1164587770 | Texas County Memorial Hospital | Pharmacy | 1422 S Sam Houston Blvd Ste 100, Houston, MO 65483 | 2006-12-26 |
| 1336226513 | Deborah Belt-kell | Counselor | Tcmh Annex - Mental Health, 1333 S Sam Houston Blvd, Houston, MO 65483 | 2006-11-01 |
| 1164483921 | Christopher O Baldwin | Obstetrics & Gynecology | 1337 S Sam Houston Blvd, Houston, MO 65483 | 2006-03-31 |
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| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871129247 | Texmed Corp | Emergency Medicine | 14770 Memorial Drive Suite 100, Houston, TX 77079-5252 | 2020-03-18 |
| 1548894751 | Emergency Medicine Physician of Houston | Emergency Medicine | 4000 Washington Ave Ste 100, Houston, TX 77007-5676 | 2020-02-26 |
| 1912472929 | Bellaire Emergency Center, LLC | Emergency Medicine | 5413 S Rice Ave, Houston, TX 77081-2113 | 2018-10-05 |
| 1295200202 | Copperfield Emergency Center, LLC | Emergency Medicine | 5835 Highway 6 N, Houston, TX 77084-1833 | 2018-10-05 |
| 1285109298 | 1960 Emergency Center, LLC | Emergency Medicine | 5003 Cypress Creek Pkwy, Houston, TX 77069-4502 | 2018-10-05 |
| 1992294748 | Khalid Mohammed S Alhamdan | Emergency Medicine | 1504 Taub Loop # I, Houston, TX 77030-1608 | 2018-05-08 |
| 1861981920 | Chloe Woodington | Emergency Medicine | 1504 Taub Loop Emergency Center, Houston, TX 77030 | 2018-05-04 |
| 1497250757 | Westchase Emergency Center, LLC | Emergency Medicine | 11103 Westheimer Rd, Houston, TX 77042 | 2018-03-28 |
| 1932617768 | Medexpress Urgent Care Texas, P.a. | Emergency Medicine | 13550 East Fwy, Houston, TX 77015-5926 | 2018-01-15 |
| 1396251781 | Medexpress Urgent Care Texas, P.a. | Emergency Medicine | 16307 Fm 529 Road, Houston, TX 77095-1417 | 2017-12-20 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.