Active NPI
Mitchell R Swanson, D.C.
- Chiropractor
- Lodi, CA
National Provider Identifier
1871697391
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- DC0160730
- Practice address
- 900 S Fairmont Ave
Suite B
Lodi, CA 95240-5143 - Phone
- (209) 368-5535
- Fax
- (209) 368-2084
- NPI assigned
- Sep 13, 2006
- 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 |
|---|---|---|---|---|
| Chiropractor | 111N00000X | DC0160730 | CA | Primary |
Addresses
Primary practice location
900 S Fairmont Ave
Suite B
Lodi, CA 95240-5143
Mailing address
900 S Fairmont Ave
Suite B
Lodi, CA 95240-5143
Phone (209) 368-5535
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120312000511 | CA | Practitioner - Chiropractic | 7517126543 | Practice locations: Lodi, CA |
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Los Angeles College of Chiropractic, 1983
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
900 S Fairmont Ave
Suite B
Lodi, CA 95240-5143
Phone (209) 368-5535
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DC0160730 | CA | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158105600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1326758400000",
"number": "1871697391",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "900 S FAIRMONT AVE",
"address_2": "SUITE B",
"city": "LODI",
"state": "CA",
"postal_code": "952405143",
"telephone_number": "209-368-5535",
"fax_number": "209-368-2084"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "900 S FAIRMONT AVE",
"address_2": "SUITE B",
"city": "LODI",
"state": "CA",
"postal_code": "952405143",
"telephone_number": "209-368-5535",
"fax_number": "209-368-2084"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SWANSON",
"first_name": "MITCHELL",
"middle_name": "R",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-13",
"last_updated": "2012-01-17",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "CA",
"license": "DC0160730",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lodi, CA
- Sutter Gould Medical Foundation (Fairmont Ave Care Center)
- Sutter Gould Medical Foundation (Kettleman Care Center)
- Sutter Valley Medical Foundation (Sutter Gould Medical Foundation)
- Robert Eugene Sutter, D.D.S.,M.S.
- Diane C. Sutton, LAC
- Chris R. Swartwood, PT
- Patrick T Sweeney, DDS
- Laurel Anne Synowicki, RN, IBCLC
- Michelle Anne Syverstad, PA-C
- Deranee Pearl G Tabor
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2012; 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.