John David Swanson IV, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

M-9075 Issued in ID

Practice address

750 N Syringa St Ste 100
Post Falls, ID 83854-5275

Phone

(208) 262-2600

Fax

(208) 262-2700

NPI assigned

Mar 26, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• North Idaho Day Surgery LLC

  • General Acute Care Hospital
  • Post Falls, ID
  • NPI 1104824739
  Medicare reassignment NPD

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724284800000",
    "number": "1255459558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1593 E POLSTON AVE",
            "city": "POST FALLS",
            "state": "ID",
            "postal_code": "838545326",
            "telephone_number": "208-262-2300",
            "fax_number": "208-262-2390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 N SYRINGA ST STE 100",
            "city": "POST FALLS",
            "state": "ID",
            "postal_code": "838545275",
            "telephone_number": "208-262-2600",
            "fax_number": "208-262-2700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "315 W Dalton Ave Ste A",
            "address_purpose": "LOCATION",
            "city": "Coeur D Alene",
            "state": "ID",
            "postal_code": "838158600",
            "country_code": "US",
            "telephone_number": "208-209-2060",
            "fax_number": "208-209-2070",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SWANSON",
        "first_name": "JOHN",
        "middle_name": "DAVID",
        "name_suffix": "IV",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-26",
        "last_updated": "2024-08-22",
        "certification_date": "2024-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083A0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Aerospace Medicine",
            "state": "ID",
            "license": "M-9075",
            "primary": false
        },
        {
            "code": "2083X0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Occupational Medicine",
            "state": "ID",
            "license": "M-9075",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "ID",
            "license": "M-9075",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1255459558",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Emergency Medicine Physician in Post Falls, ID
• Providers in Post Falls, ID by specialty
• Emergency Medicine Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.