Individual provider Active NPI

Kerry M. Severin, D.C.

  • Chiropractor
  • Alpharetta, GA
National Provider Identifier
1245385608
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIR003129 Issued in GA
Practice address
2602 Abbey CT
Alpharetta, GA 30004-6023
Phone
(770) 667-6077
Fax
(770) 667-6079
NPI assigned
Jan 24, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CHIR003129 GA Primary

Addresses

Primary practice location

2602 Abbey CT
Alpharetta, GA 30004-6023

Mailing address

2602 Abbey CT
Alpharetta, GA 30004-6023
Phone (770) 667-6077

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120314000317 GA Practitioner - Chiropractic 7618136474 Practice locations: Alpharetta, GA

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2602 Abbey Court
Alpharetta, GA 30004-6023
Phone (770) 667-6077

2602 Abbey CT
Alpharetta, GA 30004-6023

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
003129GAMDClinical Social Worker
CHIR003129GAMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1245385608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2602 ABBEY CT",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300046023",
            "telephone_number": "770-667-6077",
            "fax_number": "770-667-6079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2602 ABBEY CT",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300046023",
            "telephone_number": "770-667-6077",
            "fax_number": "770-667-6079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEVERIN",
        "first_name": "KERRY",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR003129",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alpharetta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.