Individual provider Active NPI

Kaitlyn Nicole Severson, PA-C

  • Physician Assistant
  • Coralville, IA
National Provider Identifier
1952266355
Registry record updated Feb 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
2769 Heartland Dr Ste 303
Coralville, IA 52241-2732
Phone
(319) 500-8051
NPI assigned
Dec 17, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

2769 Heartland Dr Ste 303
Coralville, IA 52241-2732

Mailing address

2769 Heartland Dr Ste 303
Coralville, IA 52241-2732
Phone (319) 500-8051

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Kaitlyn.Severson@forefrontdermatology.emadirect.md

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260327000242 IA Practitioner - Physician Assistant 0446735500 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Forefront Dermatology SCGroup PAC ID 3779471701, 650 clinicians

Practice addresses (Care Compare)

2769 Heartland Dr
Suite 303
Coralville, IA 52241-2732
Phone (319) 500-8051

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Interoperability endpoints

  • Direct secure messaging: kaitlyn.severson@forefrontdermatology.emadirect.md

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1765929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770854400000",
    "number": "1952266355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2769 HEARTLAND DR STE 303",
            "city": "CORALVILLE",
            "state": "IA",
            "postal_code": "522412732",
            "telephone_number": "319-500-8051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2769 HEARTLAND DR STE 303",
            "city": "CORALVILLE",
            "state": "IA",
            "postal_code": "522412732",
            "telephone_number": "319-500-8051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEVERSON",
        "first_name": "KAITLYN",
        "middle_name": "NICOLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-12-17",
        "last_updated": "2026-02-12",
        "certification_date": "2026-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Kaitlyn.Severson@forefrontdermatology.emadirect.md",
            "affiliation": "N",
            "address_1": "2769 Heartland Dr Ste 303",
            "city": "Coralville",
            "state": "IA",
            "country_code": "US",
            "postal_code": "522412732",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Coralville, IA

Sources for this page

Verify at the official NPI Registry.