Individual provider Active NPI

John William Swint III, PA-C

  • Physician Assistant
  • Matthews, NC
National Provider Identifier
1073716007
Registry record updated Jan 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-03056 Issued in NC
Practice address
10806 Monroe Rd Unit B
Matthews, NC 28105-7305
Phone
(980) 290-1297
Fax
(833) 499-1786
NPI assigned
Jun 7, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 005055 GA
Physician Assistant 363A00000X 0010-03056 NC Primary

Addresses

Primary practice location

10806 Monroe Rd Unit B
Matthews, NC 28105-7305

Mailing address

1332 Yellow Springs Dr
Fort Mill, SC 29707-2546
Phone (478) 256-5696

Other practice location 1

280 General Daniel Ave N
Danielsville, GA 30633-6906
Phone (706) 245-7371

Other practice location 2

7940 Williams Pond Ln Ste 150
Charlotte, NC 28277-8409
Phone (704) 752-7779

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20111010000019 NC Practitioner - Physician Assistant 8527130871 Reassigns benefits to 5 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0010-03056NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Gastonia Physician Services, PLLC CurrentSince Sep 15, 2014 Accepting new patients
Ballantyne Emergency Physicians PLLC CurrentSince May 1, 2020 Accepting new patients
Reddy Urgent Care - Royston LLC Past Accepting new patients

Locations

11516 Providence Rd
Charlotte, NC 28277
Phone (704) 667-0370

2525 Court Dr
Gastonia, NC 28054
Phone (704) 834-2662

Interoperability endpoints

  • Direct secure messaging: jswint500463@carolinashealthcaresystem.direct-ci.com
  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

Organizations & group practices 7

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": "1181174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673913600000",
    "number": "1073716007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1332 YELLOW SPRINGS DR",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "297072546",
            "telephone_number": "478-256-5696",
            "fax_number": "833-499-1786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10806 MONROE RD UNIT B",
            "city": "MATTHEWS",
            "state": "NC",
            "postal_code": "281057305",
            "telephone_number": "980-290-1297",
            "fax_number": "833-499-1786"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "280 General Daniel Ave N",
            "address_purpose": "LOCATION",
            "city": "Danielsville",
            "state": "GA",
            "postal_code": "306336906",
            "country_code": "US",
            "telephone_number": "706-245-7371",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7940 Williams Pond Ln Ste 150",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282778409",
            "country_code": "US",
            "telephone_number": "704-752-7779",
            "fax_number": "704-752-7775",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SWINT",
        "first_name": "JOHN",
        "middle_name": "WILLIAM",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-07",
        "last_updated": "2023-01-17",
        "certification_date": "2023-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "005055",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-03056",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Matthews, NC

Sources for this page

Verify at the official NPI Registry.