Individual provider Active NPI

Nosizwe Abidemi Sellers, MD

  • Hospitalist Physician
  • Duluth, GA
National Provider Identifier
1689671562
Registry record updated Jun 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
21149 Issued in SC
Practice address
3700 Crestwood Pkwy NW Ste 500
Duluth, GA 30096-5585
Phone
(803) 521-4303
NPI assigned
Jul 7, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 30, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 21149 SC
General Practice Physician 208D00000X 21149 SC
Hospitalist Physician 208M00000X 21149 SC Primary

Addresses

Primary practice location

3700 Crestwood Pkwy NW Ste 500
Duluth, GA 30096-5585

Mailing address

3700 Crestwood Pkwy NW Ste 500
Duluth, GA 30096-5585
Phone (803) 521-4303

Other practice location 1

14 Richland Medical Park Dr Ste 320
Columbia, SC 29203-6896
Phone (803) 434-6771

Other identifiers 1

IdentifierTypeStateIssuer
211498MedicaidSC

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
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
21149SCMDHospitalist Physician

NPI Registry JSON

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

{
    "created_epoch": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625011200000",
    "number": "1689671562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3700 CRESTWOOD PKWY NW STE 500",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300965585",
            "telephone_number": "803-521-4303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 CRESTWOOD PKWY NW STE 500",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300965585",
            "telephone_number": "803-521-4303"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14 Richland Medical Park Dr Ste 320",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "SC",
            "postal_code": "292036896",
            "country_code": "US",
            "telephone_number": "803-434-6771",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SELLERS",
        "first_name": "NOSIZWE",
        "middle_name": "ABIDEMI",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-07-07",
        "last_updated": "2021-06-30",
        "certification_date": "2021-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": "21149",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "SC",
            "license": "21149",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "SC",
            "license": "21149",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "211498",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 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.