Shayla Moore Sellers, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN222697 Issued in GA

Practice address

950 S Main St Ste 2
Baxley, GA 31513-0161

Phone

(912) 367-2596

NPI assigned

Mar 1, 2021

Last updated

Mar 1, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Tots to Teens Medical Center

  dba Tots To Teens Medical Ctr

  • Pediatrics Physician
  • Vidalia, GA
  • NPI 1982772182
  NPD (past)

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

{
    "created_epoch": "1614556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614556800000",
    "number": "1225622392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 GABRIEL LN",
            "city": "BAXLEY",
            "state": "GA",
            "postal_code": "315135778",
            "telephone_number": "912-278-6120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 S MAIN ST STE 2",
            "city": "BAXLEY",
            "state": "GA",
            "postal_code": "315130161",
            "telephone_number": "912-367-2596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SELLERS",
        "first_name": "SHAYLA",
        "middle_name": "MOORE",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-01",
        "last_updated": "2021-03-01",
        "certification_date": "2021-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN222697",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Nurse Practitioner in Baxley, GA
• Providers in Baxley, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2021; 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.