{
"Npi": {
"NPI": "1215464482",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "SELBY",
"FirstName": "LINDSEY",
"MiddleName": "M.",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "PA-C",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "WELDON",
"OtherFirstName": "LINDSEY",
"OtherMiddleName": "M",
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "3803 W CHESTER PIKE STE 160",
"SecondLineMailingAddress": "3803 W CHESTER PIKE STE 160",
"MailingAddressCityName": "NEWTOWN SQUARE",
"MailingAddressStateName": "PA",
"MailingAddressPostalCode": "19073-2336",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "484-227-8800",
"MailingAddressFaxNumber": "484-227-2500",
"FirstLinePracticeLocationAddress": "1088 W BALTIMORE PIKE STE 2500",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "MEDIA",
"PracticeLocationAddressStateName": "PA",
"PracticeLocationAddressPostalCode": "19063-5166",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "484-227-8800",
"PracticeLocationAddressFaxNumber": "484-227-2500",
"EnumerationDate": "05/18/2017",
"LastUpdateDate": "11/25/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "F",
"Gender": "Female",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "363A00000X",
"TaxonomyName": "Physician Assistant",
"LicenseNumber": "MA066901",
"LicenseNumberStateCode": "PA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}