Active NPI
Alicia Broadway Swann, AUDIOLOGIST
- Audiologist
- Clinton, MS
National Provider Identifier
1003004664
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- A0955
- Practice address
- 541 Highway 80 W
Suite C
Clinton, MS 39056-4193 - Phone
- (601) 488-4189
- Fax
- (601) 488-4888
- NPI assigned
- Oct 9, 2007
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Audiologist | 231H00000X | A0955 | MS | Primary |
Addresses
Primary practice location
541 Highway 80 W
Suite C
Clinton, MS 39056-4193
Mailing address
541 Highway 80 W
Auditory Processing Center
Clinton, MS 39056-4193
Phone (601) 488-4189
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00534872 | Medicaid | MS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A0955 | MS | MD | Audiologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1191888000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1414022400000",
"number": "1003004664",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "541 HIGHWAY 80 W",
"address_2": "AUDITORY PROCESSING CENTER",
"city": "CLINTON",
"state": "MS",
"postal_code": "390564193",
"telephone_number": "601-488-4189",
"fax_number": "601-488-4888"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "541 HIGHWAY 80 W",
"address_2": "SUITE C",
"city": "CLINTON",
"state": "MS",
"postal_code": "390564193",
"telephone_number": "601-488-4189",
"fax_number": "601-488-4888"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SWANN",
"first_name": "ALICIA",
"middle_name": "BROADWAY",
"credential": "AUDIOLOGIST",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-10-09",
"last_updated": "2014-10-23",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "MS",
"license": "A0955",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00534872",
"state": "MS"
}
],
"endpoints": [],
"other_names": []
}Other providers in Clinton, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.