Stephanie Sells, F.N.P.
Individual provider Active NPI Primary Care Nurse Practitioner · Halls, TN
NPI 1770908998 · NPPES record last updated Jan 28, 2015
Key facts
- NPI
- 1770908998
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Primary Care Nurse Practitioner 363LP2300X
- License
- 18502 (TN)
- Practice address
- 201 S Front St
Halls, TN 38040-1547 - Phone
- (731) 836-5617
- Fax
- (731) 836-5284
- NPI assigned
- Feb 25, 2014
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Hospital & facility affiliations 7
Owned or controlled facilities with NPI records 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- SDG Primary and Immediate Care LLC
Practice addresses (Care Compare)
201 S Front St
Halls, TN 38040-1547
Phone (731) 836-5617
Hospital & facility affiliations
- Amedisys Home Health Care
- Extendicare Home Health of West TN
- Dyersburg Regional Medical Center
- Jackson-Madison County General Hospital
- Lauderdale Community Hospital
- Baptist Memorial Hospital Tipton
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
All facility ownership & control disclosures 1
| Facility | Type | Role | Since |
|---|---|---|---|
| SDG Primary and Immediate Care LLC |
Rural health clinic | 5% Or Greater Direct Ownership Interest (50%) | Jan 1, 2015 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20140521001689 | TN | Practitioner - Nurse Practitioner | 1557584422 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 165326 | TN | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| SDG Primary and Immediate Care LLC | Current |
Accepting new patients |
Locations
201 S Front St
Halls, TN 38040
Phone (731) 836-5617
Interoperability endpoints
- stephanie.sells@spaicl-tn.direct.office.nextgen.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 165326 | TN | |
| Primary Care Nurse Practitioner | 363LP2300X | 18502 | TN | Yes |
Addresses
Primary practice location
201 S Front St
Halls, TN 38040-1547
Mailing address
201 S Front St
Halls, TN 38040-1547
Phone (731) 836-5617
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| Q004169 | Medicaid | TN |
Other providers in Halls, TN
- Jennifer Wright McWilliams
- Melinda H. Olds
- Billy Gerald Robbins
- Rural Health Clinics of West TN, PLLC
- SDG Primary and Immediate Care LLC
- Amanda Pugh Smith
- Stanley & Watts Inc
- Richard Wade Stanley
- Synergy Health Solution'S
- David Leon Watts
All providers in Halls, TN · Primary Care Nurse Practitioner in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 28, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.