Individual provider Active NPI

Ryan James Sellers, PA-C

  • Medical Physician Assistant
  • Montgomery, AL
National Provider Identifier
1780652503
Registry record updated Mar 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA.477 Issued in AL
Practice address
488 Saint Lukes Dr
Montgomery, AL 36117-7104
Phone
(334) 288-7808
Fax
(334) 288-8089
NPI assigned
Mar 9, 2006
Last updated
Mar 2, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA.477 AL
Medical Physician Assistant 363AM0700X PA.477 AL Primary

Addresses

Primary practice location

488 Saint Lukes Dr
Montgomery, AL 36117-7104

Mailing address

488 Saint Lukes Dr
Montgomery, AL 36117-7104
Phone (334) 288-7808

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20070116000164 AL Practitioner - Physician Assistant 3173537081 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
84.18 of 100Reported as group
Quality
75.76
Promoting interoperability
98
Improvement activities
40
Cost
73.18

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA.477ALMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Nes Tennessee Inc CurrentSince Jul 20, 2018 Accepting new patients
The Center for Pain of Montgomery LLC CurrentSince Feb 11, 2020 Accepting new patients
Nes Tennessee Inc CurrentSince Jul 20, 2018 Accepting new patients
The Center for Pain of Montgomery LLC CurrentSince Feb 11, 2020 Accepting new patients

Locations

1725 Pine St
Montgomery, AL 36106
Phone (334) 293-8000

2065 E South Blvd
Ste 401
Montgomery, AL 36116

488 Saint Lukes Dr
Montgomery, AL 36117
Phone (256) 496-2635

315 W Hickory St
Sylacauga, AL 35150
Phone (256) 249-5000

7300 State Highway 121
Ste 370374
McKinney, TX 75070

Organizations & group practices 7

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": "1141862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583107200000",
    "number": "1780652503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "488 SAINT LUKES DR",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361177104",
            "telephone_number": "334-288-7808",
            "fax_number": "334-288-8089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "488 SAINT LUKES DR",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361177104",
            "telephone_number": "334-288-7808",
            "fax_number": "334-288-8089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SELLERS",
        "first_name": "RYAN",
        "middle_name": "JAMES",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-09",
        "last_updated": "2020-03-02",
        "certification_date": "2020-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AL",
            "license": "PA.477",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AL",
            "license": "PA.477",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montgomery, AL

Sources for this page

Verify at the official NPI Registry.