Organization Active NPI

Steven R Sella DPM PLLC

  • Podiatrist
  • Gaylord, MI
National Provider Identifier
1073661401
Registry record updated Nov 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
SS001770 Issued in MI
Legal business name
STEVEN R SELLA DPM PLLC
Practice address
854 N Center Ave
Ste 2
Gaylord, MI 49735-1686
Phone
(989) 732-0570
Fax
(989) 732-0512
NPI assigned
Jan 8, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Steven Richard Sella, DPMNPI 1356531628
Title
Manager
Phone
(989) 732-0570

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X SS001770 MI Primary

Addresses

Primary practice location

854 N Center Ave
Ste 2
Gaylord, MI 49735-1686

Mailing address

854 N Center Ave
Ste 2
Gaylord, MI 49735-1686
Phone (989) 732-0570

Other identifiers 4

IdentifierTypeStateIssuer
M035440OtherMICHAMPUS
P88770OtherMIBLUE CARE NETWORK
3408855MedicaidMI
4856910190OtherMIBC BS

National Provider Directory

National Provider Directory

Locations

400 W Main St
Ste 114
Gaylord, MI 49735
Phone (989) 732-0570

854 N Center Ave
Unit 2
Gaylord, MI 49735
Phone (989) 732-0570

Practitioners & affiliated clinicians

Practitioners 1

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": "1168214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1415577600000",
    "number": "1073661401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "854 N CENTER AVE",
            "address_2": "STE 2",
            "city": "GAYLORD",
            "state": "MI",
            "postal_code": "497351686",
            "telephone_number": "989-732-0570",
            "fax_number": "989-732-0512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "854 N CENTER AVE",
            "address_2": "STE 2",
            "city": "GAYLORD",
            "state": "MI",
            "postal_code": "497351686",
            "telephone_number": "989-732-0570",
            "fax_number": "989-732-0512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEVEN R SELLA DPM PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-08",
        "last_updated": "2014-11-10",
        "status": "A",
        "authorized_official_last_name": "SELLA",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "RICHARD",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "989-732-0570",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "MI",
            "license": "SS001770",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHAMPUS",
            "identifier": "M035440",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CARE NETWORK",
            "identifier": "P88770",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3408855",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC BS",
            "identifier": "4856910190",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gaylord, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.