Individual provider Active NPI

Brian Douglas Swanson, PHYSICIAN ASSISTANT

  • Physician Assistant
  • Camdenton, MO
National Provider Identifier
1023031762
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2004036186 Issued in MO
Practice address
226 E US Highway 54
Camdenton, MO 65020-6819
Phone
(573) 346-3700
Fax
(573) 346-3307
NPI assigned
Jul 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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 2004036186 MO Primary

Addresses

Primary practice location

226 E US Highway 54
Camdenton, MO 65020-6819

Mailing address

226 E US Highway 54
Camdenton, MO 65020-6819
Phone (573) 346-3700

Other practice location 1

54 Hospital Dr
Osage Beach, MO 65065-3050
Phone (573) 302-3990

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20050414000141 MO Practitioner - Physician Assistant 9931150869 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lake Regional Health SystemGroup PAC ID 9133026776, 132 clinicians

Practice addresses (Care Compare)

1075 Nichols Rd
Osage Beach, MO 65065-3093
Phone (573) 302-3990

54 Hospital Dr
Osage Beach, MO 65065-3050

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.58 of 100Reported as group
Promoting interoperability
100
Improvement activities
40
Cost
65.27

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
2004036186MOMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Regional Medical Management, Inc. CurrentSince Nov 1, 2017 Accepting new patients
Lake Regional Health System CurrentSince Apr 1, 2025 Accepting new patients
Lake Regional Health System CurrentSince Apr 1, 2025 Accepting new patients

Locations

226 E US Highway 54
Camdenton, MO 65020
Phone (573) 346-3700

54 Hospital Dr
Osage Beach, MO 65065
Phone (573) 280-2772

Interoperability endpoints

  • Direct secure messaging: lakeregionalorthopedics@mhccaremail.com
  • Direct secure messaging: brianswanson@mhccaremail.com

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 2

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": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1023031762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "226 E US HIGHWAY 54",
            "city": "CAMDENTON",
            "state": "MO",
            "postal_code": "650206819",
            "telephone_number": "573-346-3700",
            "fax_number": "573-346-3307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "226 E US HIGHWAY 54",
            "city": "CAMDENTON",
            "state": "MO",
            "postal_code": "650206819",
            "telephone_number": "573-346-3700",
            "fax_number": "573-346-3307"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "54 Hospital Dr",
            "address_purpose": "LOCATION",
            "city": "Osage Beach",
            "state": "MO",
            "postal_code": "650653050",
            "country_code": "US",
            "telephone_number": "573-302-3990",
            "fax_number": "573-302-2753",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SWANSON",
        "first_name": "BRIAN",
        "middle_name": "DOUGLAS",
        "name_prefix": "Mr.",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MO",
            "license": "2004036186",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Camdenton, MO

Sources for this page

Verify at the official NPI Registry.