Dennis Eugene Severson, D.C.
Individual provider Active NPI Chiropractor · Augusta, WI
NPI 1376636878 · NPPES record last updated Nov 2, 2009
Key facts
- NPI
- 1376636878
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 2024 (WI)
- Practice address
- 154 W Lincoln St
Suite 2
Augusta, WI 54722-9152 - Phone
- (715) 225-1055
- Fax
- (715) 286-5210
- NPI assigned
- Oct 2, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Chiropractic
- Education
- Palmer College Chiropractic - Davenport, 1985
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Gateway Chiropractic Center, S.C.
Practice addresses (Care Compare)
207 W Buckman St
Augusta, WI 54722-9101
Phone (715) 225-1055
207 W Buckman St Pob
Suite 154
Augusta, WI 54722-0154
3420 Mall Dr
Suite 1
Eau Claire, WI 54701-8147
Phone (715) 832-3771
PO Box
Suite 154
Augusta, WI 54722-0154
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20041228000843 | WI | Practitioner - Chiropractic | 8820056534 |
Reassigns benefits to 1 organization Practice locations: Augusta, WI |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gateway Chiropractic Center, S.C. | Chiropractor | Current |
Accepting new patients |
| WCDC LLC | Chiropractor | Past | Accepting new patients |
Locations
3420 Mall Dr
Ste 1
Eau Claire, WI 54701
Phone (715) 832-3771
3420 Mall Dr
Ste 2
Eau Claire, WI 54701
Phone (715) 552-5254
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 2024 | WI | Yes |
Addresses
Primary practice location
154 W Lincoln St
Suite 2
Augusta, WI 54722-9152
Mailing address
154 W Lincoln St
P.O. Box 154
Augusta, WI 54722-9152
Phone (715) 225-1055
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 38790300 | Medicaid | WI | |
| 391535721014 | Other | WI | MY BC/BS |
Other providers in Augusta, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 2, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.