Individual provider Active NPI

Justin Matthew Swanson, D.C.

  • Chiropractor
  • Seattle, WA
National Provider Identifier
1003960691
Registry record updated Jun 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH00034667 Issued in WA
Practice address
3703 California Ave SW
Suite a/B
Seattle, WA 98116-3771
Phone
(206) 937-3965
Fax
(206) 937-4695
NPI assigned
Jan 22, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 17, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH00034667 WA Primary

Addresses

Primary practice location

3703 California Ave SW
Suite a/B
Seattle, WA 98116-3771

Mailing address

3703 California Ave SW
Suite a/B
Seattle, WA 98116-3771
Phone (206) 937-3965

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100225000696 WA Practitioner - Chiropractic 0648314419 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College - West, 2006
Medicare assignment
May accept Medicare assignment
Group practices
Swanson and Seepersad Chiropractic PSGroup PAC ID 0840334611, 2 clinicians

Practice addresses (Care Compare)

3703 California Ave SW
Suite a
Seattle, WA 98116-3777
Phone (206) 937-3965

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH00034667WAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Swanson & Seepersad Chiropractic, P.S. Chiropractor CurrentSince Nov 22, 2009 Accepting new patients

Locations

3703 California Ave SW
Ste A
Seattle, WA 98116
Phone (206) 937-3965

Networks

  • devoted network organization-83621310-88c0-4660-8f8d-b8ea8f4dc04e
  • WA PPO C-SNP

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": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245196800000",
    "number": "1003960691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3703 CALIFORNIA AVE SW",
            "address_2": "SUITE A/B",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981163771",
            "telephone_number": "206-937-3965",
            "fax_number": "206-937-4695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3703 CALIFORNIA AVE SW",
            "address_2": "SUITE A/B",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981163771",
            "telephone_number": "206-937-3965",
            "fax_number": "206-937-4695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWANSON",
        "first_name": "JUSTIN",
        "middle_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-22",
        "last_updated": "2009-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH00034667",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.