Robert Keethan Sellers, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

278357 Issued in AZ

Practice address

2175 W 16TH St Unit D
Safford, AZ 85546-0842

Phone

(928) 348-1600

Fax

(844) 271-2379

NPI assigned

Jul 26, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in AZ

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

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mt Graham Regional Medical Center IncGroup PAC ID 6204822364, 64 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: robert.sellers-mmmgrmc@contexture.medalliesmail.com

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.

• Mt Graham Regional Medical Center Inc

  • Critical Access Hospital
  • Safford, AZ
  • NPI 1275588345
  Medicare reassignment Care Compare group NPD
• Mt Graham Regional Medical Center Inc

  dba Copper Mountain Clinic

  • Rural Health Clinic/Center
  • Safford, AZ
  • NPI 1346528759
  NPD (past)

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

{
    "created_epoch": "1658793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665532800000",
    "number": "1881320414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2175 W 16TH ST UNIT D",
            "city": "SAFFORD",
            "state": "AZ",
            "postal_code": "855460842",
            "telephone_number": "928-348-1600",
            "fax_number": "844-271-2379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2175 W 16TH ST UNIT D",
            "city": "SAFFORD",
            "state": "AZ",
            "postal_code": "855460842",
            "telephone_number": "928-348-1600",
            "fax_number": "844-271-2379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SELLERS",
        "first_name": "ROBERT",
        "middle_name": "KEETHAN",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-07-26",
        "last_updated": "2022-10-12",
        "certification_date": "2022-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AZ",
            "license": "RN211986",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "278357",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://ehr.mtgraham.org/muglive/s0007775604768824/",
            "affiliation": "Y",
            "affiliationName": "MT GRAHAM REGIONAL MEDICAL CENTER INC",
            "address_1": "2175 W 16th St Unit D",
            "city": "Safford",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "855460842",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Vicky Schwallier
• Bryan Scott, FNP
• Gary Victor Scott, D.C.
• Mark R Scott, PA-C
• Lana Louise Selby, F.N.P.
• Kathryn Shepherd, RN
• Holly Shumway
• Seth A Skinner, D.D.S.
• Bradley R Smith, D.M.D., D.H.SC.
• Lynn E Smith, MD

• Psychiatric/Mental Health Nurse Practitioner in Safford, AZ
• Providers in Safford, AZ by specialty
• Psychiatric/Mental Health Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.