Individual provider Active NPI

Jon Swanson, D.O., PH.D.

  • Family Medicine Physician
  • Audubon, IA
National Provider Identifier
1124408299
Registry record updated Jul 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DO-06208 Issued in IA
Practice address
PO Box 27
Audubon, IA 50025-0027
Phone
(712) 304-2282
NPI assigned
Jun 4, 2015
Last updated
Jul 19, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 19, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OS019299 PA
Family Medicine Physician 207Q00000X 2335 NE
Family Medicine Physician 207Q00000X DO-06208 IA Primary

Addresses

Primary practice location

PO Box 27
Audubon, IA 50025-0027

Mailing address

PO Box 27
Audubon, IA 50025-0027
Phone (712) 304-2282

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE, IA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20201212000194 NE Practitioner - Family Practice 2860773801 Reassigns benefits to 1 organization
I20221205000348 IA Practitioner - Family Practice 2860773801 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
2335NEMDCounselor
DO-06208IAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Platte Nebraska Hospital Corporation CurrentSince Nov 23, 2020 Accepting new patients
North Platte Nebraska Hospital Corporation Current Accepting new patients

Locations

500 W Leota St
Ste 100
North Platte, NE 69101
Phone (308) 520-0548

601 W Leota St
North Platte, NE 69101
Phone (308) 534-2288

Interoperability endpoints

  • Direct secure messaging: jswanson258880@uihcdirect.org

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Accura Healthcare of North PlatteNorth Platte, NE, CCN 285165 Skilled nursing facility Operational/Managerial Control
Adp of the SNF
Apr 1, 2025
Apr 1, 2025

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 3

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": "1433376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721347200000",
    "number": "1124408299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 27",
            "city": "AUDUBON",
            "state": "IA",
            "postal_code": "500250027",
            "telephone_number": "712-304-2282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PO BOX 27",
            "city": "AUDUBON",
            "state": "IA",
            "postal_code": "500250027",
            "telephone_number": "712-304-2282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWANSON",
        "first_name": "JON",
        "name_prefix": "Dr.",
        "credential": "D.O., PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-06-04",
        "last_updated": "2024-07-19",
        "certification_date": "2024-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS019299",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NE",
            "license": "2335",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "DO-06208",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Audubon, IA

Sources for this page

Verify at the official NPI Registry.