Individual provider Active NPI

Charlotta Swain, CRNP

  • Obstetrics & Gynecology Nurse Practitioner
  • Philadelphia, PA
National Provider Identifier
1043394190
Registry record updated Oct 12, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology Nurse PractitionerTaxonomy code 363LX0001X
License
TP003928G Issued in PA
Practice address
5401 Old York Rd
Suite 400
Philadelphia, PA 19141-3030
Phone
(215) 456-3440
Fax
(215) 254-2599
NPI assigned
Oct 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Nurse Practitioner 363LX0001X TP003928G PA Primary

Addresses

Primary practice location

5401 Old York Rd
Suite 400
Philadelphia, PA 19141-3030

Mailing address

101 E Olney Ave
Suite 400
Philadelphia, PA 19120-2421
Phone (215) 456-7000

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)
Enrolled
Credentials
Certified Registered Nurse, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
TP003928GPAMDObstetrics & Gynecology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
City of Philadelphia CurrentSince Nov 25, 2013 Accepting new patients
City of Philadelphia CurrentSince Nov 25, 2013 Accepting new patients
City of Philadelphia Current Accepting new patients

Locations

1101 Market St
Fl 10
Philadelphia, PA 19107

4400 Haverford Ave
#4
Philadelphia, PA 19104
Phone (215) 685-7600

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": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1286841600000",
    "number": "1043394190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 E OLNEY AVE",
            "address_2": "SUITE 400",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191202421",
            "telephone_number": "215-456-7000",
            "fax_number": "215-254-2599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5401 OLD YORK RD",
            "address_2": "SUITE 400",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191413030",
            "telephone_number": "215-456-3440",
            "fax_number": "215-254-2599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWAIN",
        "first_name": "CHARLOTTA",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-25",
        "last_updated": "2010-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "PA",
            "license": "TP003928G",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.