1871750729 NPI number — DR. JASON SWINK MD

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1871750729 NPI number — DR. JASON SWINK MD

Employer Identification Number (EIN):

Provider Organization Name:

Provider Last Name:

SWINK

Provider First Name:

JASON

Provider Middle Name:

Provider Name Prefix Text:

DR.

Provider Name Suffix Text:

Provider Credential Text:

MD

Provider Gender Code:

M

Provider Other Organization Name:

Provider Other Organization Name Type Code:

Provider Other Last Name:

Provider Other First Name:

Provider Other Middle Name:

Provider Other Name Prefix Text:

Provider Other Name Suffix Text:

Provider Other Credential Text:

Provider Other Last Name Type Code:

NPI Number:

1871750729

Entity Type Code:

Individual

Replacement NPI:

Last Update Date:

06/02/2020

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

PO BOX 30075

Provider Second Line Business Mailing Address:

Provider Business Mailing Address City Name:

OMAHA

Provider Business Mailing Address State Name:

NE

Provider Business Mailing Address Postal Code:

68103-1175

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

816-691-5201

Provider Business Mailing Address Fax Number:

816-346-7063

Provider First Line Business Practice Location Address:

2800 CLAY EDWARDS DR

Provider Second Line Business Practice Location Address:

Provider Business Practice Location Address City Name:

KANSAS CITY

Provider Business Practice Location Address State Name:

MO

Provider Business Practice Location Address Postal Code:

64116-3220

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

816-691-5201

Provider Business Practice Location Address Fax Number:

816-346-7063

Provider Enumeration Date:

05/19/2008

Authorized Official Last Name:

Authorized Official First Name:

Authorized Official Middle Name:

Authorized Official Title or Position:

Authorized Official Telephone Number:

• Taxonomy code: 2085R0202X , with the licence number:  2017022191 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 207R00000X , with the licence number: 6929 , registered in the state of KS ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 2085R0202X , with the licence number: MD17638 , registered in the state of HI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 2085R0202X , with the licence number: 04-34841 , registered in the state of KS ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 2085R0202X , with the licence number: 53434 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 390200000X , with the licence number: 47210 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 2085R0202X , with the licence number: 27785 , registered in the state of NE ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

• Identifier: 100262773-00 , issued by the state of ( NE ) . This identifiers is of the category "MEDICAID".
• Identifier: 100262777-00 , issued by the state of ( NE ) . This identifiers is of the category "MEDICAID".
• Identifier: 1871750729 . This is a "BCBS" identifier , issued by the state of ( KS ) . This identifiers is of the category "OTHER".
• Identifier: 1871750729 , issued by the state of ( SD ) . This identifiers is of the category "MEDICAID".
• Identifier: P01507423 . This is a "RAILROAD MEDICARE- RIA KS" identifier , issued by the state of ( KS ) . This identifiers is of the category "OTHER".
• Identifier: 100262774-00 , issued by the state of ( NE ) . This identifiers is of the category "MEDICAID".
• Identifier: 820076 , issued by the state of ( AZ ) . This identifiers is of the category "MEDICAID".
• Identifier: 1871750729 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".
• Identifier: 1871750729 , issued by the state of ( WY ) . This identifiers is of the category "MEDICAID".
• Identifier: P01684145 . This is a "RR MEDICARE" identifier , issued by the state of ( KS ) . This identifiers is of the category "OTHER".
• Identifier: 1871750729 , issued by the state of ( UT ) . This identifiers is of the category "MEDICAID".
• Identifier: 840897126-00 , issued by the state of ( NE ) . This identifiers is of the category "MEDICAID".
• Identifier: 88703827 , issued by the state of ( NM ) . This identifiers is of the category "MEDICAID".
• Identifier: P01507414 . This is a "RAILROAD MEDICARE- CO RIA" identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".
• Identifier: 100262778-00 , issued by the state of ( NE ) . This identifiers is of the category "MEDICAID".
• Identifier: 200962000B , issued by the state of ( KS ) . This identifiers is of the category "MEDICAID".
• Identifier: 100262775-00 , issued by the state of ( NE ) . This identifiers is of the category "MEDICAID".
• Identifier: 100262776-00 , issued by the state of ( NE ) . This identifiers is of the category "MEDICAID".
• Identifier: 840597929-13 , issued by the state of ( NE ) . This identifiers is of the category "MEDICAID".
• Identifier: 100257090-00 , issued by the state of ( NE ) . This identifiers is of the category "MEDICAID".