Individual provider Active NPI

Bonnie Lou Sellers, RN., FNP,BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Livingston, TX
National Provider Identifier
1942210315
Registry record updated Dec 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
8K2041 Issued in TX
Practice address
1100 Ogletree Dr
Livingston, TX 77351
Phone
(936) 327-3786
Fax
(936) 327-1198
NPI assigned
Aug 9, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 8K2041 TX Primary
Family Nurse Practitioner 363LF0000X TXBNE524069 TX

Addresses

Primary practice location

1100 Ogletree Dr
Livingston, TX 77351

Mailing address

2001 S Medford Dr
Lufkin, TX 75901-6260
Phone (936) 639-1141

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20060313000555 TX Practitioner - Nurse Practitioner 0941217111 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
TXBNE524069TXMDFamily Nurse Practitioner
8K2041TXMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Burke Center CurrentSince Oct 3, 2007 Accepting new patients
Health Opportunities for the People of East Texas Family Past Accepting new patients

Locations

1100 Ogletree Dr
Livingston, TX 77352
Phone (936) 327-3786

2001 S Medford Dr
Lufkin, TX 75901
Phone (936) 633-5672

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733788800000",
    "number": "1942210315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 S MEDFORD DR",
            "city": "LUFKIN",
            "state": "TX",
            "postal_code": "759016260",
            "telephone_number": "936-639-1141",
            "fax_number": "936-634-8601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 OGLETREE DR",
            "city": "LIVINGSTON",
            "state": "TX",
            "postal_code": "77351",
            "telephone_number": "936-327-3786",
            "fax_number": "936-327-1198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SELLERS",
        "first_name": "BONNIE",
        "middle_name": "LOU",
        "credential": "RN., FNP,BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-09",
        "last_updated": "2024-12-10",
        "certification_date": "2024-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "8K2041",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "TXBNE524069",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Livingston, TX

Sources for this page

Verify at the official NPI Registry.