Erik A Severson, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

40815 Issued in WI

Practice address

2600 65TH Avenue
Osceola, WI 54020-3024

Phone

(715) 294-2111

Fax

(715) 294-5758

NPI assigned

Sep 5, 2006

Last updated

Oct 21, 2010By 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 2

Addresses

Other identifiers 2

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: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: eseverson702586@direct.ochin.org

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Ladd Memorial Hospital

  dba Osceola Medical Center

  • Critical Access Hospital
  • Osceola, WI
  • NPI 1467560227

  Corporate Director

  CMS ownership

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

• Ladd Memorial Hospital

  dba Osceola Medical Center

  • Critical Access Hospital
  • Osceola, WI
  • NPI 1467560227
  Medicare reassignment NPD
• Ladd Memorial Hospital

  dba Osceola Medical Center Osceola Clinic

  • Rural Health Clinic/Center
  • Osceola, WI
  • NPI 1801394549
  NPD
• Ladd Memorial Hospital

  dba Osceola Medical Center Scandia Clinic

  • Clinic/Center
  • Scandia, MN
  • NPI 1700195542
  NPD (past)

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

{
    "created_epoch": "1157414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287619200000",
    "number": "1851493167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 218",
            "address_2": "2600 65TH AVENUE",
            "city": "OSCEOLA",
            "state": "WI",
            "postal_code": "540203024",
            "telephone_number": "715-294-2111",
            "fax_number": "715-294-2111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 65TH AVENUE",
            "city": "OSCEOLA",
            "state": "WI",
            "postal_code": "540203024",
            "telephone_number": "715-294-2111",
            "fax_number": "715-294-5758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEVERSON",
        "first_name": "ERIK",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-05",
        "last_updated": "2010-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "47722",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "40815",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "47722",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34682800",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Osceola, WI
• Providers in Osceola, WI by specialty
• Family Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.