Derek Swoboda, DPT, ATC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

111241 Issued in IA

Practice address

20 W 6TH St Ste 101
Spencer, IA 51301-3906

Phone

(712) 580-5008

Fax

(712) 250-2415

NPI assigned

Apr 19, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hometown Physical Therapy Holding Company LLCGroup PAC ID 7214170893, 12 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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

• Hometown Physical Therapy Holding Company LLC

  dba OkobojiPhysicalTherapy,SpencerPhysicalTherapy,EastVillagePhysicalThera

  • Physical Therapist
  • Milford, IA
  • NPI 1861836454
  Medicare reassignment Care Compare group NPD
• Hometown Physical Therapy Holding Company LLC

  dba East Village Physical Therapy

  • Physical Therapist
  • Des Moines, IA
  • NPI 1952283947
  NPD

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

{
    "created_epoch": "1461024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637539200000",
    "number": "1720432479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 8TH ST N",
            "city": "MOUNTAIN LAKE",
            "state": "MN",
            "postal_code": "561591308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 W 6TH ST STE 101",
            "city": "SPENCER",
            "state": "IA",
            "postal_code": "513013906",
            "telephone_number": "712-580-5008",
            "fax_number": "712-250-2415"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1004 21st St Unit 3",
            "address_purpose": "LOCATION",
            "city": "Milford",
            "state": "IA",
            "postal_code": "513517421",
            "country_code": "US",
            "telephone_number": "712-366-8404",
            "fax_number": "712-250-2415",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SWOBODA",
        "first_name": "DEREK",
        "credential": "DPT, ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-19",
        "last_updated": "2021-11-22",
        "certification_date": "2021-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IA",
            "license": "111241",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Edwin Francisco Suaza, PA-C
• Strachia N Sullivan
• Sunshine Services Inc
• Jody Marie Surber, PA-C
• Russell Jon Sweet, HEARING AID SPECIALI
• John Benjamin Synhorst II, D.D.S
• Dennis R Taylor, O.D.
• Susan Terrell, ARNP
• There'S a Helping Hand LLC (Home Instead)
• Thomas Physical Therapy Professionals LLC

• Physical Therapist in Spencer, IA
• Providers in Spencer, IA by specialty
• Physical Therapist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.