Individual provider Active NPI

Greg G Swenson, PHD

  • Psychologist
  • Rapid City, SD
National Provider Identifier
1356493555
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
223 Issued in SD
Practice address
929 Kansas City St
Suite 201
Rapid City, SD 57701-4105
Phone
(605) 341-5436
Fax
(605) 721-5436
NPI assigned
Jan 17, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 223 SD Primary

Addresses

Primary practice location

929 Kansas City St
Suite 201
Rapid City, SD 57701-4105

Mailing address

929 Kansas City St
Suite 201
Rapid City, SD 57701-4105
Phone (605) 341-5436

Other identifiers 1

IdentifierTypeStateIssuer
6550052MedicaidSD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040417000387 SD Practitioner - Clinical Psychologist 4981698230 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

529 Kansas City St
Rapid City, SD 57701-3693
Phone (605) 341-5436

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
223SDMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Greg Swenson, PHD, Inc. Psychologist CurrentSince Jan 1, 2004 Accepting new patients

Locations

929 Kansas City St
Ste 201
Rapid City, SD 57701
Phone (605) 341-5436

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": "1168992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1356493555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "929 KANSAS CITY ST",
            "address_2": "SUITE 201",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577014105",
            "telephone_number": "605-341-5436",
            "fax_number": "605-721-5436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "929 KANSAS CITY ST",
            "address_2": "SUITE 201",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577014105",
            "telephone_number": "605-341-5436",
            "fax_number": "605-721-5436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWENSON",
        "first_name": "GREG",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "SD",
            "license": "223",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6550052",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rapid City, SD

Sources for this page

Verify at the official NPI Registry.