Individual provider Active NPI

Mark Joseph Sever, MSPT

  • Physical Therapist
  • Forestville, CA
National Provider Identifier
1972662278
Registry record updated Jan 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT11388 Issued in CA
Practice address
6478 Mirabel Rd
Forestville, CA 95436-1483
Phone
(707) 887-0185
Fax
(707) 887-1681
NPI assigned
Dec 6, 2006
Last updated
Jan 24, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 24, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT11388 CA Primary

Addresses

Primary practice location

6478 Mirabel Rd
Forestville, CA 95436-1483

Mailing address

PO Box 1483
Forestville, CA 95436-1483
Phone (707) 887-0185

Other identifiers 1

IdentifierTypeStateIssuer
PT0113880MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11388CAMDDental Hygienist
PT11388CAMDPhysical Therapist

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327363200000",
    "number": "1972662278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1483",
            "city": "FORESTVILLE",
            "state": "CA",
            "postal_code": "954361483",
            "telephone_number": "707-887-0185",
            "fax_number": "707-887-1681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6478 MIRABEL RD",
            "city": "FORESTVILLE",
            "state": "CA",
            "postal_code": "954361483",
            "telephone_number": "707-887-0185",
            "fax_number": "707-887-1681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEVER",
        "first_name": "MARK",
        "middle_name": "JOSEPH",
        "credential": "MSPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-06",
        "last_updated": "2012-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT11388",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PT0113880",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Forestville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2012; 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.