Active NPI
William Dustin Sellers, PA-C
- Physician Assistant
- Winston Salem, NC
National Provider Identifier
1154737898
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 0010-05069
- Practice address
- 2808 Maplewood Ave
Winston Salem, NC 27103-4138 - Phone
- (336) 765-9000
- NPI assigned
- Jul 2, 2014
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 0010-05069 | NC | Primary |
Addresses
Primary practice location
2808 Maplewood Ave
Winston Salem, NC 27103-4138
Mailing address
2808 Maplewood Ave
Winston Salem, NC 27103-4138
Phone (336) 765-9000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154737898 | Medicaid | NC |
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
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0010-05069 | NC | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Seashore Pediatrics | Current | Accepting new patients | |
| Columbus Regional Health Network | Past | Accepting new patients |
Interoperability endpoints
- wsellers@hanoverpeds.opdirect.net
- williamsellers@seaped.allscriptsdirect.net
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.
-
- Pediatrics Physician
- Loris, SC
- NPI 1265458251
-
- Family Medicine Physician
- Whiteville, NC
- NPI 1518263268
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1404259200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1446336000000",
"number": "1154737898",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2808 MAPLEWOOD AVE",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271034138",
"telephone_number": "336-765-9000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2808 MAPLEWOOD AVE",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271034138",
"telephone_number": "336-765-9000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SELLERS",
"first_name": "WILLIAM",
"middle_name": "DUSTIN",
"name_prefix": "Mr.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-07-02",
"last_updated": "2015-11-01",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NC",
"license": "0010-05069",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1154737898",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Winston Salem, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.