Basic Information
Provider Information
NPI: 1003802042
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SCHWINDT
FirstName: JON
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: CRNA
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 110 29TH AVE N
Address2: STE 202
City: NASHVILLE
State: TN
PostalCode: 372031401
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 110 29TH AVE N
Address2: STE 202
City: NASHVILLE
State: TN
PostalCode: 372031401
CountryCode: US
TelephoneNumber: 6153274304
FaxNumber:  
Other Information
ProviderEnumerationDate: 09/26/2005
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: X
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
367500000X052964TNY Physician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered 

ID Information
IDTypeStateIssuerDescription
7400407805KY MEDICAID
363004605TN MEDICAID
402215001TNBCBSOTHER


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