Individual provider Active NPI

Nicole Elena Sellers, NP

  • Adult Health Nurse Practitioner
  • Norfolk, VA
National Provider Identifier
1629359237
Registry record updated Mar 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
0024170205 Issued in VA
Practice address
600 Gresham Dr
Norfolk, VA 23507-1904
Phone
(757) 388-3937
NPI assigned
Sep 9, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 291244 OH
Adult Health Nurse Practitioner 363LA2200X 0024170205 VA Primary

Addresses

Primary practice location

600 Gresham Dr
Norfolk, VA 23507-1904

Mailing address

600 Gresham Dr
Norfolk, VA 23507-1904
Phone (757) 388-3937

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121114000648 VA Practitioner - Nurse Practitioner 3173781531 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Ohio State University College of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sentara Medical GroupGroup PAC ID 8921903923, 1,396 clinicians

Practice addresses (Care Compare)

2000 Meade Pkwy
Suffolk, VA 23434-4259
Phone (757) 934-9379

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
291244OHMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Sentara Medical Group CurrentSince Oct 15, 2012 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
Stafford Surgical, P.C. Past Accepting new patients

Locations

600 Gresham Dr
Norfolk, VA 23507
Phone (757) 473-0055

850 Kempsville Rd
Norfolk, VA 23502
Phone (757) 261-0162

2000 Meade Pkwy
Suffolk, VA 23434
Phone (757) 539-0251

Interoperability endpoints

  • Direct secure messaging: nsellers67666@direct.sentara.net

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 and National Provider Directory roles.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1315526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710460800000",
    "number": "1629359237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 GRESHAM DR",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235071904",
            "telephone_number": "757-388-3937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 GRESHAM DR",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235071904",
            "telephone_number": "757-388-3937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SELLERS",
        "first_name": "NICOLE",
        "middle_name": "ELENA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-09",
        "last_updated": "2024-03-15",
        "certification_date": "2024-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "291244",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "VA",
            "license": "0024170205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, VA

Sources for this page

Verify at the official NPI Registry.