Active NPI
Judith Bunnell Sellers, FNP
- Family Nurse Practitioner
- Flagstaff, AZ
National Provider Identifier
1225229107
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- AP0560
- Practice address
- 2500 N Rose St
Flagstaff, AZ 86004-3659 - Phone
- (928) 213-6100
- Fax
- (928) 774-1652
- NPI assigned
- Aug 6, 2007
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | AP0560 | AZ | Primary |
Addresses
Primary practice location
2500 N Rose St
Flagstaff, AZ 86004-3659
Mailing address
PO Box 3630
Flagstaff, AZ 86003-3630
Phone (928) 213-6121
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 720583 | Medicaid | AZ |
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
- Certified Nurse Practitioner, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 560 | AZ | MD | Low Vision Rehabilitation Optometrist |
| AP0560 | AZ | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North Country Healthcare, Inc. | Past | Accepting new patients | |
| Horizon Healthcare | Family | Past | Accepting new patients |
Interoperability endpoints
- judith.sellers.p11@direct.loraincountyhealth.nextgenshare.com
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.
-
- Multi-Specialty Clinic/Center
- Show Low, AZ
- NPI 1073740098
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1186358400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1186358400000",
"number": "1225229107",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3630",
"city": "FLAGSTAFF",
"state": "AZ",
"postal_code": "860033630",
"telephone_number": "928-213-6121",
"fax_number": "928-213-6136"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2500 N ROSE ST",
"city": "FLAGSTAFF",
"state": "AZ",
"postal_code": "860043659",
"telephone_number": "928-213-6100",
"fax_number": "928-774-1652"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SELLERS",
"first_name": "JUDITH",
"middle_name": "BUNNELL",
"credential": "FNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-08-06",
"last_updated": "2007-08-06",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "AZ",
"license": "AP0560",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "720583",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Flagstaff, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 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.