Active NPI
Jeanine Marie Swenson, M.D.
- Marriage & Family Therapist
- Glendale, WI
National Provider Identifier
1851568505
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- MT88-228
- Practice address
- 6791 N Green Bay Ave
Glendale, WI 53209-3422 - Phone
- (414) 228-4800
- Fax
- (414) 247-0894
- NPI assigned
- May 13, 2008
- Last updated
- Dec 23, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | MT88-228 | WI | Primary |
| Pediatrics Physician | 208000000X | 36627-20 | WI | |
| Pediatric Cardiology Physician | 2080P0202X | 36627 | WI |
Addresses
Primary practice location
6791 N Green Bay Ave
Glendale, WI 53209-3422
Mailing address
6791 N Green Bay Ave
Glendale, WI 53209-3422
Phone (414) 228-4800
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 Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MT88-228 | WI | MD | Marriage & Family Therapist |
| 36627-20 | WI | MD | Pediatrics Physician |
| 36627 | WI | MD | Pediatric Cardiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Advanced Healthcare SC | Pediatrics | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1210636800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1324598400000",
"number": "1851568505",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6791 N GREEN BAY AVE",
"city": "GLENDALE",
"state": "WI",
"postal_code": "532093422",
"telephone_number": "414-228-4800",
"fax_number": "414-247-0894"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6791 N GREEN BAY AVE",
"city": "GLENDALE",
"state": "WI",
"postal_code": "532093422",
"telephone_number": "414-228-4800",
"fax_number": "414-247-0894"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SWENSON",
"first_name": "JEANINE",
"middle_name": "MARIE",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-05-13",
"last_updated": "2011-12-23",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "WI",
"license": "MT88-228",
"primary": true
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "WI",
"license": "36627-20",
"primary": false
},
{
"code": "2080P0202X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Cardiology",
"state": "WI",
"license": "36627",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Glendale, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 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.