NPIMap

Individual provider Active NPI

Jack D Schwinghamer, MD

  • Family Medicine Physician
  • Mora, MN
National Provider Identifier
1457313124
Registry record updated Apr 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
42746 Issued in MN
Practice address
331 Highway 65 S
Mora, MN 55051-1899
Phone
(320) 679-1313
Fax
(320) 225-3141
NPI assigned
Apr 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2014

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X RL-0256 SD
Family Medicine Physician 207Q00000X 33011 IA
Family Medicine Physician 207Q00000X 42746 MN Primary

Addresses

Primary practice location

331 Highway 65 S
Mora, MN 55051-1899

Mailing address

PO Box 43
Mr 10809
Minneapolis, MN 55440-0043
Phone (612) 262-4813

Other identifiers 1

IdentifierTypeStateIssuer
762698300MedicaidMN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040203000284 MN Practitioner - Family Practice 6901799196 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Minnesota Medical School, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Welia HealthGroup PAC ID 6709295496, 60 clinicians

Practice addresses (Care Compare)

301 Hwy 65 S
Mora, MN 55051-1899
Phone (320) 679-1212

Hospital & facility affiliations

  • Kanabec County Community Health Home health agency, Mora, MN, CCN 247126
  • Adara Home Health Inc Home health agency, Buffalo, MN, CCN 248056
  • St Croix Hospice Hospice, Oakdale, MN, CCN 241586
  • Welia Health Hospital, Mora, MN, CCN 241367
  • Abbott Northwestern Hospital Hospital, Minneapolis, MN, CCN 240057
  • St Clare Living Community of Mora Nursing home, Mora, MN, CCN 245291
  • Welia Health Nursing home, CCN 24Z367

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
33011IAMDFamily Medicine Physician
42746MNMDFamily Medicine Physician
RL-0256SDMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Welia Health Current Accepting new patients
Welia Health CurrentSince Jan 11, 2022 Accepting new patients
Welia Health CurrentSince Jan 11, 2022 Accepting new patients
Benedictine Living Community of Mora Past Accepting new patients

Locations

301 Highway 65 S
Mora, MN 55051
Phone (320) 225-3317

331 Highway 65 S
Mora, MN 55051
Phone (320) 679-1212

Interoperability endpoints

  • Direct secure messaging: jschwinghamer26845@excellian.direct.allina.com

Ownership & related parties

All facility ownership & control disclosures 5

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Welia HealthMora, MN, CCN 241367 Hospital Corporate Director (11.11%) Jul 1, 2021
Welia HealthMora, MN, CCN 24Z367 Hospital Corporate Director (11.11%) Jul 1, 2021
St. Clare Living Community of MoraMora, MN, CCN 245291B Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Apr 1, 2020
Apr 1, 2020
Welia Health Pine CityPine City, MN, CCN 243462 Rural health clinic Corporate Director (11.11%) Jul 1, 2021
Welia Health HinckleyHinckley, MN, CCN 243463 Rural health clinic Corporate Director (11.11%) Jul 1, 2021

Owned or controlled facilities with NPI records 6

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 4

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.

Hospital & facility affiliations 30

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 30

NPI Registry JSON

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

{
    "created_epoch": "1144281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398297600000",
    "number": "1457313124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 43",
            "address_2": "MR 10809",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554400043",
            "telephone_number": "612-262-4813",
            "fax_number": "612-262-4194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "331 HIGHWAY 65 S",
            "city": "MORA",
            "state": "MN",
            "postal_code": "550511899",
            "telephone_number": "320-679-1313",
            "fax_number": "320-225-3141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHWINGHAMER",
        "first_name": "JACK",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-06",
        "last_updated": "2014-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SD",
            "license": "RL-0256",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "33011",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "42746",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "762698300",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mora, MN

Sources for this page

Verify at the official NPI Registry.