Active NPI
Donna Jean Swisher, P.T.
- Physical Therapist
- San Diego, CA
National Provider Identifier
1457411316
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT14508
- Practice address
- 3156 Sports Arena Blvd.
Suite 104
San Diego, CA 92110 - Phone
- (619) 523-6767
- Fax
- (619) 523-6769
- NPI assigned
- Dec 11, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT14508 | CA | Primary |
Addresses
Primary practice location
3156 Sports Arena Blvd.
Suite 104
San Diego, CA 92110
Mailing address
3056 Macaulay Street
San Diego, CA 92106
Phone (619) 523-6767
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 330978151 | Other | CA | TRICARE |
| 330978151 | Other | CA | TAX ID |
| 0PT145080 | Other | CA | BLUE SHIELD |
| 127149500 | Other | CA | DEPT OF LABOR OWCP |
| PT14508 | Other | CA | LICENSE NUMBER |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14508 | CA | MD | Hospitalist Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165795200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1482278400000",
"number": "1457411316",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3056 MACAULAY STREET",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "92106",
"telephone_number": "619-523-6767",
"fax_number": "619-523-6769"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3156 SPORTS ARENA BLVD.",
"address_2": "SUITE 104",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "92110",
"telephone_number": "619-523-6767",
"fax_number": "619-523-6769"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SWISHER",
"first_name": "DONNA",
"middle_name": "JEAN",
"name_prefix": "Ms.",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-11",
"last_updated": "2016-12-21",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "PT14508",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE",
"identifier": "330978151",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TAX ID",
"identifier": "330978151",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD",
"identifier": "0PT145080",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DEPT OF LABOR OWCP",
"identifier": "127149500",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE NUMBER",
"identifier": "PT14508",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.