Individual provider Active NPI

Jeffrey T Swanson, SLP

  • Speech-Language Pathologist
  • Orange City, FL
National Provider Identifier
1083730311
Registry record updated Nov 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SA 6740 Issued in FL
Practice address
963 Town Center Dr
Suite 100
Orange City, FL 32763-8254
Phone
(386) 774-9880
Fax
(386) 774-2898
NPI assigned
Mar 21, 2007
Last updated
Nov 9, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SA 6740 FL Primary

Addresses

Primary practice location

963 Town Center Dr
Suite 100
Orange City, FL 32763-8254

Mailing address

963 Town Center Dr
Suite 100
Orange City, FL 32763-8254
Phone (386) 774-9880

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
SA 6740FLMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Florida ENT Associates, Inc. PastSince Aug 17, 2016 Accepting new patients

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": "1174435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478649600000",
    "number": "1083730311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "963 TOWN CENTER DR",
            "address_2": "SUITE 100",
            "city": "ORANGE CITY",
            "state": "FL",
            "postal_code": "327638254",
            "telephone_number": "386-774-9880",
            "fax_number": "386-774-2898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "963 TOWN CENTER DR",
            "address_2": "SUITE 100",
            "city": "ORANGE CITY",
            "state": "FL",
            "postal_code": "327638254",
            "telephone_number": "386-774-9880",
            "fax_number": "386-774-2898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWANSON",
        "first_name": "JEFFREY",
        "middle_name": "T",
        "name_prefix": "Mr.",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-21",
        "last_updated": "2016-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA 6740",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange City, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2016; 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.