Active NPI
Amy L Swanholm, FNP-BC
- Family Nurse Practitioner
- Scottsdale, AZ
National Provider Identifier
1013398379
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- AP9020
- Practice address
- 11333 N Scottsdale Rd Ste 230
Scottsdale, AZ 85254-5188 - Phone
- (480) 631-7373
- Fax
- (480) 631-7374
- NPI assigned
- Jun 12, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 209012380 | IL | |
| Family Nurse Practitioner | 363LF0000X | AP9020 | AZ | Primary |
Addresses
Primary practice location
11333 N Scottsdale Rd Ste 230
Scottsdale, AZ 85254-5188
Mailing address
1807 E Oxford Dr
Tempe, AZ 85283-2250
Phone (269) 209-0125
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AZ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20161109000711 | AZ | Practitioner - Nurse Practitioner | 0244530160 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AP9020 | AZ | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cigna Health Care of Arizona Inc. | Current | Accepting new patients | |
| Cigna Healthcare of Arizona, Inc. | Current | Accepting new patients | |
| Fastrac Medical, P.C. | Past | Accepting new patients |
Locations
1717 W Chandler Blvd
Chandler, AZ 85224
Phone (480) 281-7565
4001 E Baseline Rd
Ste 107
Gilbert, AZ 85234
Phone (480) 532-4060
8888 E Raintree Dr
Fl 3
Scottsdale, AZ 85260
1920 E Baseline Rd
Tempe, AZ 85283
Phone (480) 345-5000
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Multi-Specialty Clinic/Center
- Tempe, AZ
- NPI 1649341298
-
- Multi-Specialty Clinic/Center
- Scottsdale, AZ
- NPI 1073626404
-
- Emergency Medicine Physician
- Joliet, IL
- NPI 1659517597
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1434067200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1665532800000",
"number": "1013398379",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1807 E OXFORD DR",
"city": "TEMPE",
"state": "AZ",
"postal_code": "852832250",
"telephone_number": "269-209-0125"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11333 N SCOTTSDALE RD STE 230",
"city": "SCOTTSDALE",
"state": "AZ",
"postal_code": "852545188",
"telephone_number": "480-631-7373",
"fax_number": "480-631-7374"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SWANHOLM",
"first_name": "AMY",
"middle_name": "L",
"credential": "FNP-BC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-06-12",
"last_updated": "2022-10-12",
"certification_date": "2022-10-12",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "IL",
"license": "209012380",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "AZ",
"license": "AP9020",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Scottsdale, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.