Individual provider Active NPI

Richard W Swanson, M.D.

  • Diagnostic Radiology Physician
  • Rice Lake, WI
National Provider Identifier
1306904057
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
23267 Issued in WI
Practice address
1024 N Main St
Rice Lake, WI 54868-0028
Phone
(715) 234-8151
Fax
(715) 234-7950
NPI assigned
Dec 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 23267 WI Primary

Addresses

Primary practice location

1024 N Main St
Rice Lake, WI 54868-0028

Mailing address

1024 N Main St
Rice Lake, WI 54868-1236
Phone (715) 234-8151

Other identifiers 2

IdentifierTypeStateIssuer
754024800MedicaidMN
31558800MedicaidWI

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
23267WIMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Diagnostic Radiology Associates of Wisconsin SC Diagnostic Radiology PastSince Jul 1, 1983 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1306904057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1024 N MAIN ST",
            "city": "RICE LAKE",
            "state": "WI",
            "postal_code": "548681236",
            "telephone_number": "715-234-8151",
            "fax_number": "715-234-9750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1024 N MAIN ST",
            "city": "RICE LAKE",
            "state": "WI",
            "postal_code": "548680028",
            "telephone_number": "715-234-8151",
            "fax_number": "715-234-7950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWANSON",
        "first_name": "RICHARD",
        "middle_name": "W",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-05",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WI",
            "license": "23267",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "754024800",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "31558800",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rice Lake, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.