NPIMap

Organization Active NPI

Swedishamerican Hospital

  • Surgery Physician
  • Rockford, IL
National Provider Identifier
1689729535
Registry record updated Jul 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
SWEDISHAMERICAN HOSPITAL
Practice address
1340 Charles St Ste 100
Rockford, IL 61104
Phone
(779) 696-8700
NPI assigned
Jan 23, 2007
Last updated
Jul 12, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2018

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

Authorized official

Name
Don Daniels
Title
VP
Phone
(815) 966-2084

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X NU
Surgery Physician 208600000X NU Primary

Addresses

Primary practice location

1340 Charles St Ste 100
Rockford, IL 61104

Mailing address

PO Box 78866
Milwaukee, WI 53278-8866

Other identifiers 1

IdentifierTypeStateIssuer
043OtherILTRICARE SUFFIX #

Other names 1

  • UW Health General Surgery a Department of SwedishAmerican Hospital Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031215000012 IL Part B Supplier - Clinic/Group Practice 5799698346 Receives reassigned benefits from 506 practitioners
This NPI is an additional NPI on the enrollment
Practice locations: Rockford, IL; Roscoe, IL; Belvidere, IL; Rochelle, IL; Freeport, IL; Davis Junction, IL; Byron, IL

National Provider Directory

National Provider Directory

Locations

1340 Charles St
Ste 301
Rockford, IL 61104
Phone (815) 961-2294

Practitioners & affiliated clinicians

Practitioners 20

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531353600000",
    "number": "1689729535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 78866",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532788866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1340 CHARLES ST STE 100",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "61104",
            "telephone_number": "779-696-8700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SWEDISHAMERICAN HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-23",
        "last_updated": "2018-07-12",
        "status": "A",
        "authorized_official_last_name": "DANIELS",
        "authorized_official_first_name": "DON",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "815-966-2084"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE SUFFIX #",
            "identifier": "043",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "UW Health General Surgery a Department of SwedishAmerican Hospital",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "UW Health General Surgery a Department of SwedishAmerican Hospital",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Rockford, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.