Individual provider Active NPI

Kaylan Tillie Severson, RN

  • School Registered Nurse
  • Omaha, NE
National Provider Identifier
1124793401
Registry record updated Aug 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
School Registered NurseTaxonomy code 163WS0200X
License
91517 Issued in NE
Practice address
8314 Boyd St
Omaha, NE 68134-4224
Phone
(531) 299-1141
Fax
(531) 299-1158
NPI assigned
Aug 10, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 10, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Registered Nurse 163WS0200X 91517 NE Primary

Addresses

Primary practice location

8314 Boyd St
Omaha, NE 68134-4224

Mailing address

1106 Magnolia Cir
Papillion, NE 68046-6218
Phone (402) 414-2090

Other names 1

  • Kaylan Tillie Covington Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address eseverk668@ops.org Direct Omaha Public Schools

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
91517NEMDSchool Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1628553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628553600000",
    "number": "1124793401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1106 MAGNOLIA CIR",
            "city": "PAPILLION",
            "state": "NE",
            "postal_code": "680466218",
            "telephone_number": "402-414-2090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8314 BOYD ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681344224",
            "telephone_number": "531-299-1141",
            "fax_number": "531-299-1158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEVERSON",
        "first_name": "KAYLAN",
        "middle_name": "TILLIE",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-10",
        "last_updated": "2021-08-10",
        "certification_date": "2021-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WS0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, School",
            "state": "NE",
            "license": "91517",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "eseverk668@ops.org",
            "affiliation": "Y",
            "endpointDescription": "Email",
            "affiliationName": "Omaha Public Schools",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "5105 Bedford Ave",
            "city": "Omaha",
            "state": "NE",
            "country_code": "US",
            "postal_code": "681043546",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KAYLAN",
            "last_name": "COVINGTON",
            "middle_name": "TILLIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Omaha, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2021; 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.