Individual provider Active NPI

Misty Dawn Sellers, RN

  • Administrator Registered Nurse
  • Plymouth, IN
National Provider Identifier
1114886090
Registry record updated Jan 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Administrator Registered NurseTaxonomy code 163WA2000X
License
28205621A Issued in IN
Practice address
1800 North Oak Dr
Plymouth, IN 46563
Phone
(574) 936-3784
NPI assigned
Jan 17, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 17, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Administrator Registered Nurse 163WA2000X 28205621A IN Primary

Addresses

Primary practice location

1800 North Oak Dr
Plymouth, IN 46563

Mailing address

316 W Madison St
Culver, IN 46511-1440

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
Registered Nurse

State licenses

LicenseStateTypeSpecialty
28205621AINMDAdministrator Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
HHC Indiana Inc. Past Accepting new patients
South Bend Psychiatry LLC PastSince Nov 1, 2009 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1768608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768608000000",
    "number": "1114886090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "316 W MADISON ST",
            "city": "CULVER",
            "state": "IN",
            "postal_code": "465111440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 NORTH OAK DR",
            "city": "PLYMOUTH",
            "state": "IN",
            "postal_code": "46563",
            "telephone_number": "574-936-3784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SELLERS",
        "first_name": "MISTY",
        "middle_name": "DAWN",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-01-17",
        "last_updated": "2026-01-17",
        "certification_date": "2026-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WA2000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Administrator",
            "state": "IN",
            "license": "28205621A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2026; 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.