Individual provider Active NPI

Kristy Sellers, PT

  • Specialist
  • Bella Vista, AR
National Provider Identifier
1396991022
Registry record updated Sep 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
PT2786 Issued in AR
Practice address
9 Cunningham Cor
Bella Vista, AR 72714-3520
Phone
(479) 855-6814
Fax
(479) 855-6828
NPI assigned
Aug 13, 2008
Last updated
Sep 3, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X PT2786 AR Primary

Addresses

Primary practice location

9 Cunningham Cor
Bella Vista, AR 72714-3520

Mailing address

1350 S Gutensohn Rd
Ste 10
Springdale, AR 72762-5117
Phone (479) 751-7122

Other identifiers 1

IdentifierTypeStateIssuer
131922742MedicaidAR

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PT2786ARMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Arkansas Rehabilitation Associates Past Accepting new patients
Trinity Rehabbilitation Inc Past Accepting new patients
Trinity Rehabilitation Inc Specialist Past Accepting new patients

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": "1218585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1220400000000",
    "number": "1396991022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1350 S GUTENSOHN RD",
            "address_2": "STE 10",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727625117",
            "telephone_number": "479-751-7122",
            "fax_number": "479-751-7292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 CUNNINGHAM COR",
            "city": "BELLA VISTA",
            "state": "AR",
            "postal_code": "727143520",
            "telephone_number": "479-855-6814",
            "fax_number": "479-855-6828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SELLERS",
        "first_name": "KRISTY",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-13",
        "last_updated": "2008-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "AR",
            "license": "PT2786",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "131922742",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bella Vista, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2008; 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.