Tyler James Severson, M.D.

Key facts

NPI

1104245281

Entity type

Individual (NPI type 1)

Primary specialty

Internal Medicine Physician 207R00000X

License

62263 (MN)

Practice address

2710 S Rife Medical LN
Rogers, AR 72758

Phone

(479) 636-0200

Fax

(479) 986-3448

NPI assigned

Apr 16, 2014

Sex

Male

Sole proprietor

No

Organizations & group practices 6

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.

• Mercy Health Northwest Arkansas Communities Multi-Specialty Clinic/Center · Rogers, AR · NPI 1265490916
  Medicare reassignment Care Compare group NPD AR
• Mercy Health Northwest Arkansas Communities Hospitalist Physician · Rogers, AR · NPI 1699076737
  Medicare reassignment Care Compare group NPD AR
• Mercy Health Northwest Arkansas Communities Endocrinology, Diabetes & Metabolism Physician · Rogers, AR · NPI 1770087371
  Care Compare group NPD
• Mercy Health Northwest Arkansas Communities Otolaryngology Physician · Rogers, AR · NPI 1508167677
  Care Compare group
• Mercy Health Northwest Arkansas Communities Surgery Physician · Rogers, AR · NPI 1538460662
  Care Compare group
• Mercy Hospital Rogers General Acute Care Hospital · Rogers, AR · NPI 1316902414
  NPD (past)

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Mercy Hospital Rogers General Acute Care Hospital · Rogers, AR · NPI 1316902414
  Care Compare affiliation Hospital

Medicare Care Compare profile

Specialty

Internal Medicine

Education

University of Arkansas College of Medicine, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mercy Health Northwest Arkansas Communities (314 clinicians)

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy Hospital Northwest Arkansas Hospital · Rogers, AR · CCN 040010

Medicare participation

Medicare fee-for-service enrollment

Enrolled in AR

Eligible to order & refer

Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

Yes

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tseverson1030445@directc.mercy.net

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 21, 2022.

{
    "created_epoch": "1397606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1104245281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2710 S RIFE MEDICAL LN",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727581452",
            "telephone_number": "479-636-0200",
            "fax_number": "479-986-3448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2710 S RIFE MEDICAL LN",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "72758",
            "telephone_number": "479-636-0200",
            "fax_number": "479-986-3448"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1001 E Superior St Ste L401",
            "address_purpose": "LOCATION",
            "city": "Duluth",
            "state": "MN",
            "postal_code": "558022207",
            "country_code": "US",
            "telephone_number": "218-249-7960",
            "fax_number": "218-249-7997",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SEVERSON",
        "first_name": "TYLER",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-16",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MN",
            "license": "62263",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rogers, AR

• Courtney Sellars, QBHP
• Serc Rehabilitation Partners LLC
• Servant'S Heart Outreach
• Setrek Corporation
• Melita Setser, PTA
• Margaret Lynne Sexton, APRN
• Sgoh Acquisition Inc
• Jessica Marie Shackelford
• Heather De Shaffer
• Angela Holloway Shakir, LPC

All providers in Rogers, AR · Internal Medicine Physician in Arkansas