Active NPI
Lance Robert Severson, D. C.
- Chiropractor
- Prescott, AZ
National Provider Identifier
1427025782
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 4804
- Practice address
- 416 W Goodwin St
Prescott, AZ 86303-3737 - Phone
- (928) 778-7062
- Fax
- (928) 775-2385
- NPI assigned
- Mar 7, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 4804 | AZ | Primary |
Addresses
Primary practice location
416 W Goodwin St
Prescott, AZ 86303-3737
Mailing address
4878 N Socorro Dr
Prescott Valley, AZ 86314-7136
Phone (928) 778-7062
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4804 | AZ | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1141689600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1427025782",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4878 N SOCORRO DR",
"city": "PRESCOTT VALLEY",
"state": "AZ",
"postal_code": "863147136",
"telephone_number": "928-778-7062",
"fax_number": "928-775-2385"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "416 W GOODWIN ST",
"city": "PRESCOTT",
"state": "AZ",
"postal_code": "863033737",
"telephone_number": "928-778-7062",
"fax_number": "928-775-2385"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SEVERSON",
"first_name": "LANCE",
"middle_name": "ROBERT",
"name_prefix": "Dr.",
"credential": "D. C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-07",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "AZ",
"license": "4804",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Prescott, AZ
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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.