Individual provider Active NPI

Nykkia N Sellers, APN

  • Family Nurse Practitioner
  • West Memphis, AR
National Provider Identifier
1134316250
Registry record updated Mar 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APN0000012901 Issued in TN
Practice address
700 N Missouri St Ste 2
West Memphis, AR 72301-3150
Phone
(870) 551-4409
NPI assigned
Oct 2, 2007
Last updated
Mar 28, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APN0000012901 TN Primary

Addresses

Primary practice location

700 N Missouri St Ste 2
West Memphis, AR 72301-3150

Mailing address

6025 Stage Rd # 42-349
Bartlett, TN 38134-8374
Phone (901) 249-0755

Other practice location 1

5220 Park Ave Ste 202
Memphis, TN 38119-3547
Phone (901) 744-3362

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, AR2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20151110000662 TN Practitioner - Nurse Practitioner 6204019649 Reassigns benefits to 2 organizations
I20220509000504 AR Practitioner - Nurse Practitioner 6204019649 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

512 Graham St
West Memphis, AR 72301-3136
Phone (901) 249-0755

700 N Missouri St
Suite 2
West Memphis, AR 72301-3150

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
12901TNMDPhysical Therapist
APN0000012901TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Diabetes Wellness NP, PLLC CurrentSince Jun 13, 2022 Accepting new patients
Endo 247 LLC CurrentSince Jul 1, 2022 Accepting new patients
Midsouth Independent Group, PLLC CurrentSince Oct 15, 2021 Accepting new patients

Locations

512 Graham St
West Memphis, AR 72301
Phone (901) 249-0755

700 N Missouri St
Ste 2
West Memphis, AR 72301
Phone (870) 551-4409

875 W Poplar Ave
Ste 23
Collierville, TN 38017

5220 Park Ave
Ste 202
Memphis, TN 38119
Phone (901) 305-5040

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1191283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648425600000",
    "number": "1134316250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6025 STAGE RD # 42-349",
            "city": "BARTLETT",
            "state": "TN",
            "postal_code": "381348374",
            "telephone_number": "901-249-0755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 N MISSOURI ST STE 2",
            "city": "WEST MEMPHIS",
            "state": "AR",
            "postal_code": "723013150",
            "telephone_number": "870-551-4409"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5220 Park Ave Ste 202",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381193547",
            "country_code": "US",
            "telephone_number": "901-744-3362",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SELLERS",
        "first_name": "NYKKIA",
        "middle_name": "N",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-02",
        "last_updated": "2022-03-28",
        "certification_date": "2022-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "APN0000012901",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Memphis, AR

Sources for this page

Verify at the official NPI Registry.