Individual provider Active NPI

Jordan Edward Swisher, DO

  • Cardiovascular Disease Physician
  • Milwaukee, WI
National Provider Identifier
1366936056
Registry record updated Jul 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
8144121 Issued in WI
Practice address
2900 W Oaklahoma Ave.
Milwaukee, WI 53215
Phone
(414) 550-6961
Fax
(313) 343-8747
NPI assigned
Jun 18, 2018
Last updated
Jul 1, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 5101024176 MI
Cardiovascular Disease Physician 207RC0000X 8144121 WI Primary

Addresses

Primary practice location

2900 W Oaklahoma Ave.
Milwaukee, WI 53215

Mailing address

2900 W Oaklahoma Ave.
Milwaukee, WI 53215
Phone (414) 550-6961

Other identifiers 2

IdentifierTypeStateIssuer
8144121OtherWIWISCONSIN MEDICAL LICENSE
5101024176OtherMIMICHIGAN LIMITED EDUCATIONAL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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 1

Enrollment IDStateProvider typePAC IDDetails
I20180702000751 MI Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 3870849094

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
8144121WIMDCardiovascular Disease Physician

NPI Registry JSON

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

{
    "created_epoch": "1529280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719792000000",
    "number": "1366936056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 W OAKLAHOMA AVE.",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "53215",
            "telephone_number": "414-550-6961",
            "fax_number": "313-343-8747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 W OAKLAHOMA AVE.",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "53215",
            "telephone_number": "414-550-6961",
            "fax_number": "313-343-8747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWISHER",
        "first_name": "JORDAN",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-18",
        "last_updated": "2024-07-01",
        "certification_date": "2024-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "5101024176",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "WI",
            "license": "8144121",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WISCONSIN MEDICAL LICENSE",
            "identifier": "8144121",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MICHIGAN LIMITED EDUCATIONAL LICENSE",
            "identifier": "5101024176",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.