Laurie A Severn, LPTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

5502002524 Issued in MI

Practice address

2609 Charlevoix Ave
Petoskey, MI 49770

Phone

(231) 439-3750

Fax

(231) 439-5918

NPI assigned

Nov 9, 2012

Sex

Female

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/20203/brand/1/csg/1/fhir/r4

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

• First Choice Physical Therapy, Inc

  • Physical Therapy Clinic/Center
  • Petoskey, MI
  • NPI 1619031010
  NPD (past)
• PGPT, LLC

  • Physical Therapy Clinic/Center
  • Petoskey, MI
  • NPI 1083456834
  NPD (past)

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

{
    "created_epoch": "1352419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521072000000",
    "number": "1558615757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2609 CHARLEVOIX AVE",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "49770",
            "telephone_number": "231-439-3750",
            "fax_number": "231-439-5918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2609 CHARLEVOIX AVE",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "49770",
            "telephone_number": "231-439-3750",
            "fax_number": "231-439-5918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEVERN",
        "first_name": "LAURIE",
        "middle_name": "A",
        "credential": "LPTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-09",
        "last_updated": "2018-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MI",
            "license": "5502002524",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Second Chance Counseling Center
• Robert John Seledotis, D.O., P.C.
• Brenna Sellman
• Sernity Home Care
• Joann Servant, DNP,PMHNP-BC,FNP-BC
• Anton A. Sharapov, M.D.
• Marcia Shattuck, MD
• Gary H Shaw, M.D.
• Robert Scott Sheperd, DDS
• Todd M Sheperd, MD

• Physical Therapy Assistant in Petoskey, MI
• Providers in Petoskey, MI by specialty
• Physical Therapy Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.