Active NPI
Sellerssportsmed LLC
- Sports Medicine (Family Medicine) Physician
- Tempe, AZ
National Provider Identifier
1003373507
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Sports Medicine (Family Medicine) Physician
- Legal business name
- SELLERSSPORTSMED LLC
- Practice address
- 1840 E Baseline Rd Ste C2
Tempe, AZ 85283-1528 - Phone
- (480) 751-3777
- Fax
- (480) 751-3785
- NPI assigned
- Feb 21, 2019
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Joel S Sellers, DO
- Title
- Physician
- Phone
- (480) 426-2667
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Sports Medicine (Family Medicine) Physician | 207QS0010X | Primary | ||
| Primary Care Clinic/Center | 261QP2300X |
Addresses
Primary practice location
1840 E Baseline Rd Ste C2
Tempe, AZ 85283-1528
Mailing address
1840 E Baseline Rd Ste C2
Tempe, AZ 85283-1528
Phone (480) 751-3777
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AZ
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
1840 E Baseline Rd
Ste C2
Tempe, AZ 85283
Phone (480) 751-3777
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1550707200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1561939200000",
"number": "1003373507",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1840 E BASELINE RD STE C2",
"city": "TEMPE",
"state": "AZ",
"postal_code": "852831528",
"telephone_number": "480-751-3777",
"fax_number": "480-751-3785"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1840 E BASELINE RD STE C2",
"city": "TEMPE",
"state": "AZ",
"postal_code": "852831528",
"telephone_number": "480-751-3777",
"fax_number": "480-751-3785"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SELLERSSPORTSMED LLC",
"organizational_subpart": "NO",
"enumeration_date": "2019-02-21",
"last_updated": "2019-07-01",
"status": "A",
"authorized_official_last_name": "SELLERS",
"authorized_official_first_name": "JOEL",
"authorized_official_middle_name": "S",
"authorized_official_title_or_position": "PHYSICIAN",
"authorized_official_telephone_number": "480-426-2667",
"authorized_official_credential": "DO"
},
"taxonomies": [
{
"code": "207QS0010X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine, Sports Medicine",
"state": null,
"license": null,
"primary": true
},
{
"code": "261QP2300X",
"taxonomy_group": "",
"desc": "Clinic/Center, Primary Care",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tempe, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.