Thomas R. Swanson OD, Inc

Primary specialty

OptometristTaxonomy code 152W00000X

License

65701T Issued in CA

Legal business name

THOMAS R. SWANSON OD, INC

Practice address

1821 Douglas Blvd Ste C4
Roseville, CA 95661-2910

Phone

(916) 786-6633

Fax

(916) 786-6617

NPI assigned

Oct 20, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Thomas R Swanson, OD

Title

President Owner

Phone

(916) 786-6633

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1357257600000",
    "number": "1558443200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1821 DOUGLAS BLVD",
            "address_2": "SUITE C4",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956612910",
            "telephone_number": "916-786-6633",
            "fax_number": "916-786-6617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1821 DOUGLAS BLVD STE C4",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956612910",
            "telephone_number": "916-786-6633",
            "fax_number": "916-786-6617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THOMAS R. SWANSON OD, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-20",
        "last_updated": "2013-01-04",
        "status": "A",
        "authorized_official_last_name": "SWANSON",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT OWNER",
        "authorized_official_telephone_number": "916-786-6633",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "65701T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DE3871",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0065700",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF CALIFORNIA",
            "identifier": "ZZZ66845Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Roseville, CA
• Providers in Roseville, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2013; 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.