NPIMap

Individual provider Active NPI

Travis Swink

  • Family Medicine Physician
  • Dwight, IL
National Provider Identifier
1619060977
Registry record updated Nov 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036-104289 Issued in IL
Practice address
105 S John St
Dwight, IL 60420-1413
Phone
(815) 584-3343
Fax
(815) 584-3647
NPI assigned
Oct 1, 2006
Last updated
Nov 27, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036-104289 IL Primary

Addresses

Primary practice location

105 S John St
Dwight, IL 60420-1413

Mailing address

1916 N Main St
Princeton, IL 61356-9786
Phone (815) 664-0605

Other identifiers 1

IdentifierTypeStateIssuer
036104289MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050725000505 IL Practitioner - Family Practice 2769420231 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Oklahoma State University College of Osteopathic Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Osf Healthcare SystemGroup PAC ID 4284541806, 94 clinicians

Practice addresses (Care Compare)

327 Edward St
Osf Healthcare Medical Group Henry
Henry, IL 61537-1539
Phone (309) 364-2002

530 Park Ave E
303B Osf Healthcare Medical Group Princeton
Princeton, IL 61356-3903
Phone (815) 876-3350

535 Park Ave E
Princeton, IL 61356-2537
Phone (815) 875-4531

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
3701OKMDDentist
036-104289ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Osf Healthcare System CurrentSince Jun 19, 2023 Accepting new patients
Osf Healthcare System CurrentSince Jun 19, 2023 Accepting new patients
Central PA Pharmacy LLC. Current Accepting new patients
Osf Healthcare System Current Accepting new patients
Jackson County Memorial Hospital Authority PastSince Dec 31, 2008 Accepting new patients
Jackson County Memorial Hospital Authority Past Accepting new patients
Illinois Emergency Physicians LLP Past Accepting new patients
Osf Healthcare System Past Accepting new patients

Locations

327 Edward St
Henry, IL 61537
Phone (309) 364-2002

1000 W Harlem Ave
Monmouth, IL 61462
Phone (309) 734-1414

124 SW Adams St
Peoria, IL 61602
Phone (309) 655-2850

8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050

535 Park Ave E
Princeton, IL 61356
Phone (815) 875-4531

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1159660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574812800000",
    "number": "1619060977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1916 N MAIN ST",
            "city": "PRINCETON",
            "state": "IL",
            "postal_code": "613569786",
            "telephone_number": "815-664-0605",
            "fax_number": "815-664-0507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 S JOHN ST",
            "city": "DWIGHT",
            "state": "IL",
            "postal_code": "604201413",
            "telephone_number": "815-584-3343",
            "fax_number": "815-584-3647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWINK",
        "first_name": "TRAVIS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-01",
        "last_updated": "2019-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036-104289",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036104289",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dwight, IL

Sources for this page

Verify at the official NPI Registry.