Individual provider Active NPI

Karen Kelli Severson, OCCUPATIONAL THERAPI

  • Pediatric Occupational Therapist
  • Clackamas, OR
National Provider Identifier
1043065733
Registry record updated Apr 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
1016752 Issued in OR
Practice address
13455 SE 97TH Ave
Clackamas, OR 97015-8662
Phone
(503) 675-4259
NPI assigned
Apr 17, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X 1016752 OR Primary

Addresses

Primary practice location

13455 SE 97TH Ave
Clackamas, OR 97015-8662

Mailing address

13455 SE 97TH Ave
Clackamas, OR 97015-8662
Phone (503) 675-4259

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1016752ORMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Clackamas Education Service District CurrentSince Apr 21, 2024 Accepting new patients
Clackamas Education Service District CurrentSince Feb 23, 2025 Accepting new patients

Locations

13455 SE 97th Ave
Clackamas, OR 97015
Phone (503) 675-4000

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": "1713312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713312000000",
    "number": "1043065733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13455 SE 97TH AVE",
            "city": "CLACKAMAS",
            "state": "OR",
            "postal_code": "970158662",
            "telephone_number": "503-675-4259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13455 SE 97TH AVE",
            "city": "CLACKAMAS",
            "state": "OR",
            "postal_code": "970158662",
            "telephone_number": "503-675-4259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEVERSON",
        "first_name": "KAREN",
        "middle_name": "KELLI",
        "name_prefix": "Mrs.",
        "credential": "OCCUPATIONAL THERAPI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-17",
        "last_updated": "2024-04-17",
        "certification_date": "2024-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "OR",
            "license": "1016752",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clackamas, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2024; 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.