Jesse Swann, DPT
Individual provider Active NPI Physical Therapist · Belen, NM
NPI 1508314428 · NPPES record last updated Sep 20, 2016
Key facts
- NPI
- 1508314428
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 4915 (NM)
- Practice address
- 1220 Camino del Llano
Belen, NM 87002-2727 - Phone
- (505) 861-1200
- Fax
- (505) 861-1220
- NPI assigned
- Sep 20, 2016
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4915 | NM | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Paradigm Physical Therapy and Wellness Inc | Physical Therapist | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 4915 | NM | Yes |
Addresses
Primary practice location
1220 Camino del Llano
Belen, NM 87002-2727
Mailing address
535 Hwy 314 SW
Los Lunas, NM 87031-9600
Phone (505) 866-0055
Other providers in Belen, NM
- Becky Spinar
- Samantha Stidstone
- Jay J Stuttler
- Sunrise Clinics
- Sunshine Kids Therapy, LLC
- Roger Swanson
- Brittney Michelle Tavasci
- Sarah Taylor
- Amber Teal
- Joyce Thomas
All providers in Belen, NM · Physical Therapist in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 20, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.