Individual provider Active NPI

John Robert Swenson, DPM

  • Podiatrist
  • Colorado Springs, CO
National Provider Identifier
1184616278
Registry record updated Nov 30, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
474 Issued in CO
Practice address
2287 Rocking Horse CT
Colorado Springs, CO 80921-6401
Phone
(719) 473-6677
Fax
(719) 473-9219
NPI assigned
Aug 16, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 30, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 474 CO Primary

Addresses

Primary practice location

2287 Rocking Horse CT
Colorado Springs, CO 80921-6401

Mailing address

2287 Rocking Horse CT
Colorado Springs, CO 80921-6401
Phone (719) 473-6677

Other identifiers 1

IdentifierTypeStateIssuer
01004746MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071211000011 CO Practitioner - Podiatry 0547359754 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
California School of Podiatric Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

12205 Gunstock Dr
Colorado Springs, CO 80921-3624
Phone (719) 481-9494

2045 Roanoke St
Colorado Springs, CO 80906-3451
Phone (719) 471-2285

2287 Rocking Horse CT
Colorado Springs, CO 80921-6401

2850 N Academy Blvd
Colorado Springs, CO 80917-5306
Phone (719) 637-0877

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1379
Removal or shaving of skin growth1379

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
236NEMDCounselor
474COMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
John R. Swenson DPM, PC Podiatrist CurrentSince Aug 12, 1993 Accepting new patients

Locations

2045 Roanoke St
Colorado Springs, CO 80906
Phone (719) 471-2285

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": "1124150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1291075200000",
    "number": "1184616278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2287 ROCKING HORSE CT",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809216401",
            "telephone_number": "719-473-6677",
            "fax_number": "719-473-9219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2287 ROCKING HORSE CT",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809216401",
            "telephone_number": "719-473-6677",
            "fax_number": "719-473-9219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWENSON",
        "first_name": "JOHN",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-16",
        "last_updated": "2010-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "CO",
            "license": "474",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01004746",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.