Active NPI
Jason Lee Swain
- Physical Therapist
- Bonaire, GA
National Provider Identifier
1578850343
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT010295
- Practice address
- 101 Stillwater Cir
Bonaire, GA 31005-3857 - Phone
- (478) 293-1680
- NPI assigned
- Jun 30, 2011
- Sex
- Male
- 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 | PT010295 | GA | Primary |
Addresses
Primary practice location
101 Stillwater Cir
Bonaire, GA 31005-3857
Mailing address
1900 Wesleyan Dr
Apt 101
Macon, GA 31210-8807
Phone (662) 312-6911
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 |
|---|---|---|---|
| PT010295 | GA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1309392000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1309392000000",
"number": "1578850343",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1900 WESLEYAN DR",
"address_2": "APT 101",
"city": "MACON",
"state": "GA",
"postal_code": "312108807",
"telephone_number": "662-312-6911"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 STILLWATER CIR",
"city": "BONAIRE",
"state": "GA",
"postal_code": "310053857",
"telephone_number": "478-293-1680"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SWAIN",
"first_name": "JASON",
"middle_name": "LEE",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-06-30",
"last_updated": "2011-06-30",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "GA",
"license": "PT010295",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bonaire, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.