Provider Demographics
NPI:1871750729
Name:SWINK, JASON (MD)
Entity type:Individual
Prefix:DR
First Name:JASON
Middle Name:
Last Name:SWINK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 30075
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68103-1175
Mailing Address - Country:US
Mailing Address - Phone:816-691-5201
Mailing Address - Fax:816-346-7063
Practice Address - Street 1:2800 CLAY EDWARDS DR
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64116-3220
Practice Address - Country:US
Practice Address - Phone:816-691-5201
Practice Address - Fax:816-346-7063
Is Sole Proprietor?:No
Enumeration Date:2008-05-19
Last Update Date:2020-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20170221912085R0202X
KS6929207R00000X
HIMD176382085R0202X
KS04-348412085R0202X
CO534342085R0202X
AZ47210390200000X
NE277852085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE100262773-00Medicaid
NE100262777-00Medicaid
KS1871750729OtherBCBS
SD1871750729Medicaid
KSP01507423OtherRAILROAD MEDICARE- RIA KS
NE100262774-00Medicaid
AZ820076Medicaid
IA1871750729Medicaid
WY1871750729Medicaid
KSP01684145OtherRR MEDICARE
UT1871750729Medicaid
NE840897126-00Medicaid
NM88703827Medicaid
COP01507414OtherRAILROAD MEDICARE- CO RIA
NE100262778-00Medicaid
KS200962000BMedicaid
NE100262775-00Medicaid
NE100262776-00Medicaid
NE840597929-13Medicaid
NE100257090-00Medicaid
MT1871750729Medicaid
KS200962000CMedicaid
UT1871750729Medicaid
NEP01428940Medicare PIN
NENA1214087Medicare PIN
AZZ159593Medicare PIN
WY1871750729Medicaid
NE100262776-00Medicaid
NE100262774-00Medicaid
CO348161YQN9Medicare PIN
KS1871750729OtherBCBS
NE100262778-00Medicaid
NE100257090-00Medicaid
NEP01348687Medicare PIN
KSKA3249070Medicare PIN