Individual provider Active NPI

Clinton Sellers, DC, MS, CCSP

  • Chiropractor
  • Raleigh, NC
National Provider Identifier
1174975700
Registry record updated Dec 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4646 Issued in NC
Practice address
3948 Browning PL Ste 110
Raleigh, NC 27609-6512
Phone
(919) 699-8184
Fax
(919) 480-2757
NPI assigned
Jul 7, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Physician Chiropractor 111NS0005X 4646 NC
Rehabilitation Chiropractor 111NR0400X 4646 NC
Chiropractor 111N00000X 4646 NC Primary

Addresses

Primary practice location

3948 Browning PL Ste 110
Raleigh, NC 27609-6512

Mailing address

3948 Browning PL Ste 110
Raleigh, NC 27609-6512
Phone (919) 699-8184

Other names 1

  • Dr. Clint Sellers Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address contact@peakchiropracticnc.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200106001974 NC Practitioner - Chiropractic 0941634844 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
4646NCMDRehabilitation Chiropractor

Organizations & group practices 1

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": "1467849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733270400000",
    "number": "1174975700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3948 BROWNING PL STE 110",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276096512",
            "telephone_number": "919-699-8184",
            "fax_number": "919-480-2757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3948 BROWNING PL STE 110",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276096512",
            "telephone_number": "919-699-8184",
            "fax_number": "919-480-2757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SELLERS",
        "first_name": "CLINTON",
        "name_prefix": "Dr.",
        "credential": "DC, MS, CCSP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-07-07",
        "last_updated": "2024-12-04",
        "certification_date": "2024-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "NC",
            "license": "4646",
            "primary": false
        },
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "NC",
            "license": "4646",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "4646",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "contact@peakchiropracticnc.com",
            "affiliation": "N",
            "address_1": "211 E Six Forks Rd Ste 207",
            "city": "Raleigh",
            "state": "NC",
            "country_code": "US",
            "postal_code": "276097755",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "CLINT",
            "last_name": "SELLERS",
            "prefix": "DR.",
            "credential": "DC, MS, CCSP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.