Individual provider Active NPI

Heather Elaine Swanson, M.D.

  • Psychiatry Physician
  • Spring Lake Park, MN
National Provider Identifier
1407112253
Registry record updated Jul 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
57109 Issued in MN
Practice address
7766 Highway 65 NE
Spring Lake Park, MN 55432-2832
Phone
(763) 205-4843
Fax
(612) 416-2085
NPI assigned
Apr 5, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 29, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Psychiatry Physician 2084P0802X 57109 MN
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X 57109 MN Primary

Addresses

Primary practice location

7766 Highway 65 NE
Spring Lake Park, MN 55432-2832

Mailing address

7766 Highway 65 NE
Spring Lake Park, MN 55432-2832
Phone (763) 205-4843

Other practice location 1

1 Veterans Dr # 116A
Minneapolis, MN 55417-2309
Phone (612) 467-1504

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20251113000285 MN Practitioner - Psychiatry 8921325739 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of Minnesota Medical School, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

2701 University Ave SE
Suite 204
Minneapolis, MN 55414-3236
Phone (763) 205-4843

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
57109MNMDAddiction Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Expanse - a Minnesota Mental Health Ketamine & Psychedelic Psychother Multi-Specialty CurrentSince Nov 1, 2025 Accepting new patients

Locations

2701 University Ave SE
Minneapolis, MN 55414
Phone (612) 627-3500

2701 University Ave SE
Ste 204
Minneapolis, MN 55414
Phone (763) 205-4843

7766 Highway 65 NE
Spring Lake Park, MN 55432
Phone (763) 205-4843

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": "1333584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753747200000",
    "number": "1407112253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7766 HIGHWAY 65 NE",
            "city": "SPRING LAKE PARK",
            "state": "MN",
            "postal_code": "554322832",
            "telephone_number": "763-205-4843",
            "fax_number": "612-416-2085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7766 HIGHWAY 65 NE",
            "city": "SPRING LAKE PARK",
            "state": "MN",
            "postal_code": "554322832",
            "telephone_number": "763-205-4843",
            "fax_number": "612-416-2085"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Veterans Dr # 116A",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554172309",
            "country_code": "US",
            "telephone_number": "612-467-1504",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SWANSON",
        "first_name": "HEATHER",
        "middle_name": "ELAINE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-04-05",
        "last_updated": "2025-07-29",
        "certification_date": "2025-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0802X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Psychiatry",
            "state": "MN",
            "license": "57109",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MN",
            "license": "57109",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spring Lake Park, MN

Sources for this page

Verify at the official NPI Registry.