Eric F Severson, PA-C

Primary specialty

Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X

License

115763 Issued in AK

Practice address

3066 E Meridian Park Loop Ste 207
Wasilla, AK 99654-7254

Phone

(907) 357-7710

Fax

(907) 357-7720

NPI assigned

Oct 31, 2005

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 AK

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Advanced Pain Centers of Alaska, Inc

  • Pain Medicine (Anesthesiology) Physician
  • Anchorage, AK
  • NPI 1073618583
  Medicare reassignment

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

{
    "created_epoch": "1130716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522195200000",
    "number": "1790776599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3066 E MERIDIAN PARK LOOP",
            "address_2": "STE 3",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996547254",
            "telephone_number": "907-357-7710",
            "fax_number": "907-357-7720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3066 E MERIDIAN PARK LOOP STE 207",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996547254",
            "telephone_number": "907-357-7710",
            "fax_number": "907-357-7720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEVERSON",
        "first_name": "ERIC",
        "middle_name": "F",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-31",
        "last_updated": "2018-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "AK",
            "license": "115763",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Set Free Alaska, Inc.
• Set Free Alaska, Inc.
• Set Free Alaska, Inc.
• Set Free Alaska, Inc.
• Sophie Marie Severance Paterson, RN
• SH Massage and Wellness LLC
• Kelly Shafer
• Ingrid Doris Shaginoff, MS RD LN
• James S Shaha, M.D.
• Shalom Assisted Living Home LLC

• Interventional Pain Medicine Physician in Wasilla, AK
• Providers in Wasilla, AK by specialty
• Interventional Pain Medicine Physician in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.