Individual provider Active NPI

Marissa Swindle, CRNA

  • Student in an Organized Health Care Education/Training Program
  • Fairhope, AL
National Provider Identifier
1124449822
Registry record updated Dec 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
39 Issued in AL
Practice address
750 Morphy Ave
Fairhope, AL 36532-1812
Phone
(251) 990-1109
NPI assigned
Dec 23, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 23, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 39 AL Primary

Addresses

Primary practice location

750 Morphy Ave
Fairhope, AL 36532-1812

Mailing address

14599 Samuel Williams LN
Fairhope, AL 36532-5605
Phone (251) 990-3642

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140305000942 AL Practitioner - Certified Registered Nurse Anesthetist (Crna) 4587894910 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eastern Shore Anesthesia, P.C.Group PAC ID 9830089978, 42 clinicians

Practice addresses (Care Compare)

750 Morphy Ave
Fairhope, AL 36532-1812
Phone (251) 990-1109

Hospital & facility affiliations

  • Thomas Hospital Hospital, Fairhope, AL, CCN 010100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
39ALMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Mobile Infirmary Association CurrentSince Sep 17, 2019 Accepting new patients
Eastern Shore Anesthesia PC CurrentSince Dec 15, 2013 Accepting new patients
Gulf Regional Pathologists PA Current Accepting new patients
Mobile Infirmary Association CurrentSince Sep 17, 2019 Accepting new patients

Locations

27961 US Highway 98
Daphne, AL 36526
Phone (251) 435-6850

750 Morphy Ave
Fairhope, AL 36532
Phone (251) 928-2375

5 Mobile Infirmary Cir
Mobile, AL 36607
Phone (251) 432-4415

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1387756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1387756800000",
    "number": "1124449822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14599 SAMUEL WILLIAMS LN",
            "city": "FAIRHOPE",
            "state": "AL",
            "postal_code": "365325605",
            "telephone_number": "251-990-3642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 MORPHY AVE",
            "city": "FAIRHOPE",
            "state": "AL",
            "postal_code": "365321812",
            "telephone_number": "251-990-1109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWINDLE",
        "first_name": "MARISSA",
        "name_prefix": "Mrs.",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-12-23",
        "last_updated": "2013-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "AL",
            "license": "39",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairhope, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.