Individual provider Active NPI

Connor Douglas Swartz, DO

  • Student in an Organized Health Care Education/Training Program
  • Stockton, CA
National Provider Identifier
1851973317
Registry record updated Jun 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
0116041588 Issued in VA
Practice address
1800 N California St
Stockton, CA 95204-6019
Phone
(209) 547-5941
NPI assigned
Apr 24, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 0116041588 VA Primary

Addresses

Primary practice location

1800 N California St
Stockton, CA 95204-6019

Mailing address

1215 Lee St # 801008
Charlottesville, VA 22908-0816

Other practice location 1

19555 N 59th Ave
Glendale, AZ 85308-6813
Phone (623) 572-3215

Other practice location 2

1215 Lee St # 801008
Charlottesville, VA 22908-0816
Phone (434) 243-5676

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230710002642 MO Order and Referring Only - Physical Medicine and RehabilitationPractitioner - Physical Medicine and RehabilitationPractitioner - Pain Management 5294194130

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2023018522MOMDPhysical Medicine & Rehabilitation Physician

NPI Registry JSON

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

{
    "created_epoch": "1619222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781136000000",
    "number": "1851973317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1215 LEE ST # 801008",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229080816",
            "fax_number": "434-243-5689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 N CALIFORNIA ST",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952046019",
            "telephone_number": "209-547-5941"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "19555 N 59th Ave",
            "address_purpose": "LOCATION",
            "city": "Glendale",
            "state": "AZ",
            "postal_code": "853086813",
            "country_code": "US",
            "telephone_number": "623-572-3215",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1215 Lee St # 801008",
            "address_purpose": "LOCATION",
            "city": "Charlottesville",
            "state": "VA",
            "postal_code": "229080816",
            "country_code": "US",
            "telephone_number": "434-243-5676",
            "fax_number": "434-243-5689",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SWARTZ",
        "first_name": "CONNOR",
        "middle_name": "DOUGLAS",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-24",
        "last_updated": "2026-06-11",
        "certification_date": "2026-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "VA",
            "license": "0116041588",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockton, CA

Sources for this page

Verify at the official NPI Registry.