Shirley J Swenson, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

F33435 Issued in NY

Practice address

15 S Main St
Suite 160
Jamestown, NY 14701-6636

Phone

(716) 484-7107

Fax

(716) 664-2500

NPI assigned

Jun 14, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NY

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Great Lakes Physician Practice PC

  • Internal Medicine Physician
  • Jamestown, NY
  • NPI 1730599176
  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455753600000",
    "number": "1053354035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 S MAIN ST",
            "address_2": "SUITE 300",
            "city": "JAMESTOWN",
            "state": "NY",
            "postal_code": "147016636",
            "telephone_number": "716-484-7107",
            "fax_number": "716-664-2500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 S MAIN ST",
            "address_2": "SUITE 160",
            "city": "JAMESTOWN",
            "state": "NY",
            "postal_code": "147016636",
            "telephone_number": "716-484-7107",
            "fax_number": "716-664-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWENSON",
        "first_name": "SHIRLEY",
        "middle_name": "J",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-14",
        "last_updated": "2016-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F33435",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2556958",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "J400168891",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michelle A Swabik, LMFT
• Chantel Marie Swanson, PHARMD
• Jeanette Swanson
• Julie L Swanson
• Sara Swanson, NP
• Nicole Rae Szymczak, PT, DPT
• Luke William Tackentien, NP
• Tanglewood Manor, Inc
• Laurie Tanner, R.N.
• Stacey Lynn Teagarden

• Family Nurse Practitioner in Jamestown, NY
• Providers in Jamestown, NY by specialty
• Family Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2016; 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.

Verify at the official NPI Registry.