Grant R. Swanson, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

070-019510 Issued in IL

Practice address

765 N Kellogg St
3Rd Floor
Galesburg, IL 61401-2875

Phone

(309) 343-3434

Fax

(309) 343-3456

NPI assigned

Sep 25, 2012

Last updated

Sep 25, 2012By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1348531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348531200000",
    "number": "1457602849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 N WILLIAMSBURG DR",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617043528",
            "telephone_number": "309-661-8823",
            "fax_number": "309-881-8801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "765 N KELLOGG ST",
            "address_2": "3RD FLOOR",
            "city": "GALESBURG",
            "state": "IL",
            "postal_code": "614012875",
            "telephone_number": "309-343-3434",
            "fax_number": "309-343-3456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWANSON",
        "first_name": "GRANT",
        "middle_name": "R.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-09-25",
        "last_updated": "2012-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070-019510",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hephzibah Sudhakar, PT
• Heather Sullivan, PHARMD.
• Timothy F Sullivan, CRNA
• Scott William Sunderland, MS, ATC
• Surgical Clinics LTD
• Laura L. Swanson, OT
• Douglas Swarts, RPH
• Tyler Swedeen
• Mark Joseph Switzer, L.AC.
• Andrea Tenley, RDN, LDN

• Physical Therapist in Galesburg, IL
• Providers in Galesburg, IL by specialty
• Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.