NPIMap

Individual provider Active NPI

Joel C Swanson, MD

  • Internal Medicine Physician
  • Eagle, ID
National Provider Identifier
1013956705
Registry record updated Oct 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
M8006 Issued in ID
Practice address
323 E Riverside Dr, Suite 224
Samg Ehp Family Medicine
Eagle, ID 83616-6815
Phone
(208) 302-6000
Fax
(208) 302-6055
NPI assigned
Jun 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X M8006 ID Primary

Addresses

Primary practice location

323 E Riverside Dr, Suite 224
Samg Ehp Family Medicine
Eagle, ID 83616-6815

Mailing address

PO Box 190930
Boise, ID 83719-0930
Phone (208) 367-5180

Other identifiers 1

IdentifierTypeStateIssuer
805814100MedicaidID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100522000043 ID Practitioner - Internal Medicine 1759361678 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Medical College of Wisconsin, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Saint Alphonsus Regional Medical Center IncGroup PAC ID 3476462359, 672 clinicians

Practice addresses (Care Compare)

3025 W Cherry LN
Meridian, ID 83642-8531

323 E Riverside Dr
Suite 224
Eagle, ID 83616-6865
Phone (208) 302-6000

Hospital & facility affiliations

  • Enhabit Home Health & Hospice Home health agency, Boise, ID, CCN 137006
  • First Choice Home Care Home health agency, Boise, ID, CCN 137108
  • Horizon Home Health Home health agency, Meridian, ID, CCN 137065
  • Saint Alphonsus Regional Medical Center Hospital, Boise, ID, CCN 130007
  • Saint Alphonsus Medical Center - Nampa Hospital, Nampa, ID, CCN 130013
  • St Luke'S Regional Medical Center Hospital, Boise, ID, CCN 130006

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
M8006IDMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Alphonsus Regional Medical Center Inc CurrentSince Jan 2, 2008 Accepting new patients
Saint Alphonsus Regional Medical Center Inc Current Accepting new patients
Saint Alphonsus Regional Medical Center Inc Internal Medicine CurrentSince Jan 2, 2008 Accepting new patients
West Valley Medical Group LLC Internal Medicine PastSince Oct 1, 2006 Accepting new patients

Locations

315 E Elm St
Ste 100
Caldwell, ID 83605
Phone (208) 302-7100

1717 Arlington Ave
Caldwell, ID 83605
Phone (208) 455-3719

323 E Riverside Dr
Ste 224
Eagle, ID 83616
Phone (208) 302-6000

3340 E Goldstone Dr
Meridian, ID 83642
Phone (208) 302-9342

3025 W Cherry Ln
Meridian, ID 83642
Phone (208) 302-6400

3025 W Cherry Ln
Ste B
Meridian, ID 83642
Phone (208) 302-6400

Interoperability endpoints

  • Direct secure messaging: jswanson1564100@direct.trinity-health.org

Organizations & group practices 4

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.

Hospital & facility affiliations 11

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728950400000",
    "number": "1013956705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 190930",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837190930",
            "telephone_number": "208-367-5180",
            "fax_number": "208-367-5180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "323 E RIVERSIDE DR, SUITE 224",
            "address_2": "SAMG EHP FAMILY MEDICINE",
            "city": "EAGLE",
            "state": "ID",
            "postal_code": "836166815",
            "telephone_number": "208-302-6000",
            "fax_number": "208-302-6055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWANSON",
        "first_name": "JOEL",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-06",
        "last_updated": "2024-10-15",
        "certification_date": "2024-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "ID",
            "license": "M8006",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "805814100",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Eagle, ID

Sources for this page

Verify at the official NPI Registry.