Individual provider Active NPI

Amy L Swanholm, FNP-BC

  • Family Nurse Practitioner
  • Scottsdale, AZ
National Provider Identifier
1013398379
Registry record updated Oct 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP9020 Issued in AZ
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

Updated by the provider on Oct 12, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161109000711 AZ Practitioner - Nurse Practitioner 0244530160

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP9020AZMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cigna Health Care of Arizona Inc. CurrentSince Aug 28, 2017 Accepting new patients
Cigna Healthcare of Arizona, Inc. CurrentSince Aug 28, 2017 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.

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

Verify at the official NPI Registry.