Individual provider Active NPI

Jessica Ann Swink, DPT

  • Physical Therapist
  • Faribault, MN
National Provider Identifier
1467796607
Registry record updated May 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
11335 Issued in MN
Practice address
828 1St St NE
Faribault, MN 55021-5438
Phone
(612) 364-1901
NPI assigned
Nov 10, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 17, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT60232224 WA
Physical Therapist 225100000X 11335 MN Primary

Addresses

Primary practice location

828 1St St NE
Faribault, MN 55021-5438

Mailing address

1611 N Madison St
Tacoma, WA 98406-4709
Phone (360) 951-2387

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181126000252 MN Practitioner - Physical Therapist in Private Practice 9537413935 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Big Stone Therapies, IncGroup PAC ID 1254655434, 16 clinicians

Practice addresses (Care Compare)

900 Cannon Valley Dr
Suite A118
Northfield, MN 55057-1334
Phone (507) 646-9495

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT60232224WAMDPhysical Therapist
11335MNMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Big Stone Therapies, Inc Physical Therapist CurrentSince Mar 18, 2024 Accepting new patients
Odom Sports Medicine, P.a. CurrentSince Sep 15, 2018 Accepting new patients
Big Stone Therapies Montague LLC Physical Therapist Past Accepting new patients
Big Stone Therapies Baxter, LLC Physical Therapist Past Accepting new patients
Legacy Primary Care PLLC PastSince Jul 7, 2024 Accepting new patients

Locations

6545 Flying Cloud Dr
Ste 201
Eden Prairie, MN 55344
Phone (612) 364-1901

10653 Wayzata Blvd
Ste 200
Minnetonka, MN 55305
Phone (612) 364-1901

900 Cannon Valley Dr E
Ste A118
Northfield, MN 55057
Phone (507) 646-9495

900 Cannon Valley Dr E
Ste 118A
Northfield, MN 55057

500 Cross St
Big Stone Cty, SD 57216
Phone (605) 541-1140

Organizations & group practices 5

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": "1352505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684281600000",
    "number": "1467796607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1611 N MADISON ST",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984064709",
            "telephone_number": "360-951-2387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "828 1ST ST NE",
            "city": "FARIBAULT",
            "state": "MN",
            "postal_code": "550215438",
            "telephone_number": "612-364-1901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWINK",
        "first_name": "JESSICA",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-11-10",
        "last_updated": "2023-05-17",
        "certification_date": "2023-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT60232224",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "11335",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Faribault, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.