Individual provider Active NPI

Teresa Sellars, N.P.

  • Psychiatric/Mental Health Nurse Practitioner
  • Sierra Vista, AZ
National Provider Identifier
1124115191
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
AP2378 Issued in AZ
Practice address
185 S Moorman Ave
Sierra Vista, AZ 85635-2700
Phone
(520) 458-3932
Fax
(520) 458-3585
NPI assigned
Oct 9, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP2378 AZ Primary

Addresses

Primary practice location

185 S Moorman Ave
Sierra Vista, AZ 85635-2700

Mailing address

489 N Arroyo Blvd
Nogales, AZ 85621-2644
Phone (520) 287-4713

Other identifiers 2

IdentifierTypeStateIssuer
098665OtherAZAHCCCS NO.
98665MedicaidAZ

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)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP2378AZMDPsychiatric/Mental Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1160352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124115191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "489 N ARROYO BLVD",
            "city": "NOGALES",
            "state": "AZ",
            "postal_code": "856212644",
            "telephone_number": "520-287-4713",
            "fax_number": "520-287-9794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "185 S MOORMAN AVE",
            "city": "SIERRA VISTA",
            "state": "AZ",
            "postal_code": "856352700",
            "telephone_number": "520-458-3932",
            "fax_number": "520-458-3585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SELLARS",
        "first_name": "TERESA",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "AP2378",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AHCCCS NO.",
            "identifier": "098665",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "98665",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sierra Vista, AZ

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.

Verify at the official NPI Registry.