MRS. SELINA LOUISE BROADAWAY CPNP-AC
NPI 1124765714
Nurse Practitioner - Pediatrics, Critical Care in Memphis, TN
About Mrs. Selina Louise Broadaway Cpnp-ac NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MRS. SELINA LOUISE BROADAWAY CPNP-AC (NPI 1124765714) is an individual pediatrics, critical care provider in Memphis, Tennessee, licensed in Tennessee (31660) and active in the NPI registry since May 2022. She is enrolled in Medicare PECOS and maintains a secondary practice location in Memphis.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Secondary Practice Location 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Mrs. Selina Louise Broadaway Cpnp-ac is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignments
2Medicare enrollment records show Selina Broadaway reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Memphis, TN 38105
- Reassigned Medicare billing, Tennessee enrollment
- Medicare enrollment name: St Jude Childrens Research Hospital Inc
- 367 clinicians in this Medicare group
Memphis, TN 38103
- Reassigned Medicare billing, Tennessee enrollment
- 582 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 38105 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
MEMPHIS, TN 38105
MEMPHIS, TN 38105
MEMPHIS, TN 38105
MEMPHIS, TN 38105
MEMPHIS, TN 38105
MEMPHIS, TN 38105
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Selina Broadaway's NPI number?
The NPI number for Selina Broadaway is 1124765714. It was assigned to this individual provider in the NPPES registry on May 16, 2022. The provider is also known as Selina Louise Ribnick.
Where is Selina Broadaway located?
Selina Broadaway practices at 262 Danny Thomas Pl, Memphis, TN 38105. The listed phone number is (888) 226-4343.
What is Selina Broadaway's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Pediatrics, Critical Care, with taxonomy code 363LP0222X.
Is Selina Broadaway enrolled in Medicare?
Yes. Selina Broadaway is registered in the Medicare PECOS enrollment system.
Which organizations bill Medicare for Selina Broadaway's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Selina Broadaway reassigns Medicare benefits to 2 organizations: St Jude Children's Research Hospital, Inc. (Memphis, TN) and Ut Lebonheur Pediatric Specialists, Inc. (Memphis, TN). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Selina Broadaway's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Selina Broadaway was last updated on February 7, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Mrs. Selina Louise Broadaway, CPNP-AC · NPI 1124765714
Pediatrics, Critical Care physician in Memphis, Tennessee. Individual provider, active in the CMS NPPES registry since May 16, 2022.
## Identity
- **NPI:** 1124765714 (Entity type: Individual)
- **Enumerated:** May 16, 2022
- **Primary specialty:** Nurse Practitioner - Pediatrics, Critical Care · taxonomy 363LP0222X
- **State license:** 31660 (Tennessee)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 262 DANNY THOMAS PL, Memphis, TN 38105-3678
- **Phone:** (888) 226-4343
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): St Jude Children's Research Hospital, Inc. (NPI 1306335088, Memphis, TN); Ut Lebonheur Pediatric Specialists, Inc. (NPI 1093024101, Memphis, TN) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** February 7, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1124765714) · Data from the CMS NPPES public registry.