Active NPI
Richard Patrick Swenson, PH.D.
- Intellectual & Developmental Disabilities Psychologist
- Idaho Falls, ID
National Provider Identifier
1811297443
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Intellectual & Developmental Disabilities Psychologist
- License
- 214
- Practice address
- 1147 E 25TH St
Idaho Falls, ID 83404-7007 - Phone
- (208) 525-8615
- Fax
- (208) 525-8615
- NPI assigned
- Oct 29, 2010
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Intellectual & Developmental Disabilities Psychologist | 103TM1800X | 214 | ID | Primary |
Addresses
Primary practice location
1147 E 25TH St
Idaho Falls, ID 83404-7007
Mailing address
1147 E 25TH St
Idaho Falls, ID 83404-7007
Phone (208) 525-8615
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 214 | ID | MD | Intellectual & Developmental Disabilities Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1288310400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1288310400000",
"number": "1811297443",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1147 E 25TH ST",
"city": "IDAHO FALLS",
"state": "ID",
"postal_code": "834047007",
"telephone_number": "208-525-8615",
"fax_number": "208-525-8615"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1147 E 25TH ST",
"city": "IDAHO FALLS",
"state": "ID",
"postal_code": "834047007",
"telephone_number": "208-525-8615",
"fax_number": "208-525-8615"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SWENSON",
"first_name": "RICHARD",
"middle_name": "PATRICK",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-10-29",
"last_updated": "2010-10-29",
"status": "A"
},
"taxonomies": [
{
"code": "103TM1800X",
"taxonomy_group": "",
"desc": "Psychologist, Intellectual & Developmental Disabilities",
"state": "ID",
"license": "214",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Idaho Falls, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.