Individual provider Active NPI

Courtney Swallows, PA

  • Medical Physician Assistant
  • Orlando, FL
National Provider Identifier
1023699758
Registry record updated Jan 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA9114698 Issued in FL
Practice address
1222 S Orange Ave FL 4
Orlando, FL 32806-1215
Phone
(321) 841-6444
Fax
(407) 650-1307
NPI assigned
Apr 15, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 3, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X PA9114698 FL
Medical Physician Assistant 363AM0700X PA9114698 FL Primary

Addresses

Primary practice location

1222 S Orange Ave FL 4
Orlando, FL 32806-1215

Mailing address

1222 S Orange Ave FL 4
Orlando, FL 32806-1215
Phone (321) 841-6444

Other practice location 1

303 N Clyde Morris Blvd
Daytona Beach, FL 32114-2709
Phone (386) 425-1700

Other practice location 2

3300 E Halifax Crossing Blvd
Deltona, FL 32725-2911
Phone (386) 425-1700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20211018001684 FL Practitioner - Physician Assistant 3678971934 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA9114698FLMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Orlando Health Medical Group Inc Multi-Specialty CurrentSince Dec 1, 2022 Accepting new patients
Orlando Health, Inc. Current Accepting new patients
Halifax Healthcare Systems Inc Multi-Specialty CurrentSince Oct 4, 2021 Accepting new patients

Locations

303 N Clyde Morris Blvd
Daytona Beach, FL 32114
Phone (386) 425-2285

3300 E Halifax Crossing Blvd
Deltona, FL 32725
Phone (386) 425-1800

32 W Gore St
Orlando, FL 32806
Phone (321) 841-3820

1222 S Orange Ave
Fl 4
Orlando, FL 32806
Phone (321) 841-7700

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: cswallows409724@orlandohealth.medalliesdirect.net

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": "1618444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735862400000",
    "number": "1023699758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1222 S ORANGE AVE FL 4",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328061215",
            "telephone_number": "321-841-6444",
            "fax_number": "407-650-1307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1222 S ORANGE AVE FL 4",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328061215",
            "telephone_number": "321-841-6444",
            "fax_number": "407-650-1307"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "303 N Clyde Morris Blvd",
            "address_purpose": "LOCATION",
            "city": "Daytona Beach",
            "state": "FL",
            "postal_code": "321142709",
            "country_code": "US",
            "telephone_number": "386-425-1700",
            "fax_number": "386-425-1704",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3300 E Halifax Crossing Blvd",
            "address_purpose": "LOCATION",
            "city": "Deltona",
            "state": "FL",
            "postal_code": "327252911",
            "country_code": "US",
            "telephone_number": "386-425-1700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SWALLOWS",
        "first_name": "COURTNEY",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-15",
        "last_updated": "2025-01-03",
        "certification_date": "2025-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9114698",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9114698",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.