Kyle P. Everson, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

7059 Issued in WI

Practice address

1501 W Stout St
Rice Lake, WI 54868-5001

Phone

(715) 236-8900

NPI assigned

Apr 4, 2013

Last updated

Jul 2, 2013By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1365033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372723200000",
    "number": "1467795799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 N OAK AVE",
            "city": "MARSHFIELD",
            "state": "WI",
            "postal_code": "544495703",
            "telephone_number": "715-387-5511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 W STOUT ST",
            "city": "RICE LAKE",
            "state": "WI",
            "postal_code": "548685001",
            "telephone_number": "715-236-8900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVERSON",
        "first_name": "KYLE",
        "middle_name": "P.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-04",
        "last_updated": "2013-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "7059",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachel Engel, D.D.S.
• Daniel Erickson, MD
• Stephanie Erickson, PT
• Natasha Eshbaugh, MD
• Susan Espeseth
• Brad Harold Ewald, O.D.
• Madyson Falstad, RBT
• Joanne L Faltz Bailey, LCSW
• Family Health Center of Marshfield Inc (Family Health Center - Rice Lake Dental Center)
• Courtney Fedie, OTR

• General Practice Dentistry in Rice Lake, WI
• Providers in Rice Lake, WI by specialty
• General Practice Dentistry in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.