Active NPI
Douglas Robert Swinehart, M.D.
- Dermatology Physician
- Fresno, CA
National Provider Identifier
1144214230
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- G415040
- Practice address
- 6335 N Fresno St
Suite 201
Fresno, CA 93710-5272 - Phone
- (559) 432-1212
- Fax
- (559) 432-6669
- NPI assigned
- Sep 6, 2005
- Reactivated
- Apr 19, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Procedural Dermatology Physician | 207NS0135X | G415040 | CA | |
| Dermatology Physician | 207N00000X | G415040 | CA | Primary |
| Dermatopathology Physician | 207ND0900X | G415040 | CA |
Addresses
Primary practice location
6335 N Fresno St
Suite 201
Fresno, CA 93710-5272
Mailing address
6335 N Fresno St
Suite 201
Fresno, CA 93710-5272
Phone (559) 432-1212
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00G415040 | Medicaid | CA |
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 |
|---|---|---|---|
| G415040 | CA | MD | Dermatopathology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fresno Community Hospital and Medical Center | Past | Accepting new patients |
Organizations & group practices 1
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.
-
dba Community Regional Medical Center
- General Acute Care Hospital
- Fresno, CA
- NPI 1104906569
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1125964800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1434326400000",
"number": "1144214230",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6335 N FRESNO ST",
"address_2": "SUITE 201",
"city": "FRESNO",
"state": "CA",
"postal_code": "937105272",
"telephone_number": "559-432-1212",
"fax_number": "559-432-6669"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6335 N FRESNO ST",
"address_2": "SUITE 201",
"city": "FRESNO",
"state": "CA",
"postal_code": "937105272",
"telephone_number": "559-432-1212",
"fax_number": "559-432-6669"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SWINEHART",
"first_name": "DOUGLAS",
"middle_name": "ROBERT",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-09-06",
"last_updated": "2015-06-15",
"deactivation_date": "2006-03-25",
"reactivation_date": "2006-04-19",
"status": "A"
},
"taxonomies": [
{
"code": "207NS0135X",
"taxonomy_group": "",
"desc": "Dermatology, Procedural Dermatology",
"state": "CA",
"license": "G415040",
"primary": false
},
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "CA",
"license": "G415040",
"primary": true
},
{
"code": "207ND0900X",
"taxonomy_group": "",
"desc": "Dermatology, Dermatopathology",
"state": "CA",
"license": "G415040",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00G415040",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fresno, CA
- Whitney Swengel
- Alicia Jane Swenson O'Brien, LCSW
- Debbra Lyn Swenson, LVN
- Christine E Swift, RN. MSN
- Swiftride Medical Transportation Inc
- Mandeep Syal
- Sycamore Grove Healthcare LLC (Ardent Home Health of Fresno)
- Sycamore Grove Healthcare LLC (Ardent Hospice of Fresno)
- Noah Northen Sydnor
- Zaneb Khalid Syed, D.O
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.