Active NPI
Walter Jackson Sellers, MA
- Psychologist
- Henderson, NC
National Provider Identifier
1023124229
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 401
- Practice address
- 804 S Garnett St
Henderson, NC 27536 - Phone
- (252) 430-7442
- NPI assigned
- Aug 21, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 401 | NC | Primary |
Addresses
Primary practice location
804 S Garnett St
Henderson, NC 27536
Mailing address
10 Sedgewood Rd
Chapel Hill, NC 27514
Phone (919) 942-8445
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 401 | NC | MD | Hearing Instrument Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156118400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1023124229",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10 SEDGEWOOD RD",
"city": "CHAPEL HILL",
"state": "NC",
"postal_code": "27514",
"telephone_number": "919-942-8445"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "804 S GARNETT ST",
"city": "HENDERSON",
"state": "NC",
"postal_code": "27536",
"telephone_number": "252-430-7442"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SELLERS",
"first_name": "WALTER",
"middle_name": "JACKSON",
"name_prefix": "Mr.",
"credential": "MA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-21",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NC",
"license": "401",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Henderson, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.