NPIMap

Individual provider Active NPI

Josie Marie Syverson, M.D.

  • Family Medicine Physician
  • Pocatello, ID
National Provider Identifier
1154760528
Registry record updated Jul 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MRM-1343 Issued in ID
Practice address
465 Memorial Dr
Pocatello, ID 83201-4008
Phone
(208) 282-4700
NPI assigned
Jun 19, 2013
Last updated
Jul 1, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MRM-1343 ID Primary

Addresses

Primary practice location

465 Memorial Dr
Pocatello, ID 83201-4008

Mailing address

465 Memorial Dr
Pocatello, ID 83201-4008
Phone (208) 282-4700

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jsyverson305423@direct.centracare.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160803002136 MN Practitioner - Family Practice 7618119173 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Minnesota Medical School, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Glacial Ridge Hospital DistrictGroup PAC ID 5294789194, shared by 7 NPIs, 69 clinicians
Centracare Health - Benson LLCGroup PAC ID 1850761685, 12 clinicians
Swift County-Benson HospitalGroup PAC ID 8729069281, 9 clinicians

Practice addresses (Care Compare)

10 4TH Ave SE
Glenwood, MN 56334-1820
Phone (320) 634-4521

1815 Wisconsin Ave
Benson, MN 56215-1653
Phone (320) 843-4232

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Centracare Health - Benson LLC CurrentSince Jun 24, 2023 Accepting new patients
Glacial Ridge Hospital District CurrentSince Jul 1, 2024 Accepting new patients
Carris Health LLC CurrentSince Dec 1, 2024 Accepting new patients
Swift County Benson Hospital Family Medicine CurrentSince Sep 1, 2016 Accepting new patients
Swift County-Benson Hospital Current Accepting new patients
Glacial Ridge Hospital District Family Medicine Current Accepting new patients
Centracare Health - Benson LLC Current Accepting new patients
Carris Health LLC CurrentSince Dec 1, 2024 Accepting new patients
Glacial Ridge Hospital District CurrentSince Jul 1, 2024 Accepting new patients
Minnesota Pathologists Chartered Current Accepting new patients

Locations

1810 McKinney Ave
Benson, MN 56215
Phone (320) 843-2030

1815 Wisconsin Ave
Benson, MN 56215
Phone (320) 843-3454

10 4th Ave SE
Glenwood, MN 56334
Phone (320) 634-5157

417 Franklin St S
Glenwood, MN 56334
Phone (320) 634-5157

101 Willmar Ave SW
Willmar, MN 56201
Phone (320) 231-5079

301 Becker Ave SW
Willmar, MN 56201
Phone (320) 231-4120

Interoperability endpoints

  • FHIR API: https://fhir-usa.unify.chbase.com/org/glac-1755385c
  • Direct secure messaging: jsyverson305423@direct.centracare.com

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

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

NPI Registry JSON

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

{
    "created_epoch": "1371600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719792000000",
    "number": "1154760528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "465 MEMORIAL DR",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832014008",
            "telephone_number": "208-282-4700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "465 MEMORIAL DR",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832014008",
            "telephone_number": "208-282-4700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SYVERSON",
        "first_name": "JOSIE",
        "middle_name": "MARIE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-19",
        "last_updated": "2024-07-01",
        "certification_date": "2024-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ID",
            "license": "MRM-1343",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jsyverson305423@direct.centracare.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "jsyverson305423@direct.centracare.com",
            "address_1": "1815 Wisconsin Ave",
            "city": "Benson",
            "state": "MN",
            "country_code": "US",
            "postal_code": "562151653",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Pocatello, ID

Sources for this page

Verify at the official NPI Registry.