Active NPI
James William Swallow, MD
- Internal Medicine Physician
- Fort Bragg, CA
National Provider Identifier
1114067287
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- G29367
- Practice address
- 721 River Drive
Suite a
Fort Bragg, CA 95437 - Phone
- (707) 961-4631
- Fax
- (707) 964-1192
- NPI assigned
- Feb 7, 2007
- Last updated
- Sep 27, 2012
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | G29367 | CA | Primary |
Addresses
Primary practice location
721 River Drive
Suite a
Fort Bragg, CA 95437
Mailing address
721 River Drive
Suite a
Fort Bragg, CA 95437
Phone (707) 961-4631
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00G293670 | Other | CA | MEDICAL |
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
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G29367 | CA | MD | Internal Medicine Physician |
| 29367 | CA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170806400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1348704000000",
"number": "1114067287",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "721 RIVER DRIVE",
"address_2": "SUITE A",
"city": "FORT BRAGG",
"state": "CA",
"postal_code": "95437",
"telephone_number": "707-961-4631",
"fax_number": "707-964-1192"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "721 RIVER DRIVE",
"address_2": "SUITE A",
"city": "FORT BRAGG",
"state": "CA",
"postal_code": "95437",
"telephone_number": "707-961-4631",
"fax_number": "707-964-1192"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SWALLOW",
"first_name": "JAMES",
"middle_name": "WILLIAM",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-02-07",
"last_updated": "2012-09-27",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "CA",
"license": "G29367",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL",
"identifier": "00G293670",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fort Bragg, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.