Individual provider Active NPI

Brenda K Swain, A.R.N.P.

  • Nurse Practitioner
  • Fort Sill, OK
National Provider Identifier
1154323301
Registry record updated Aug 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
R0033710 Issued in OK
Practice address
4301 Wilson St
ENT Clinic
Fort Sill, OK 73503-4472
Phone
(580) 558-2453
Fax
(580) 558-2427
NPI assigned
Jun 1, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X R0033710 OK Primary

Addresses

Primary practice location

4301 Wilson St
ENT Clinic
Fort Sill, OK 73503-4472

Mailing address

4301 Wilson St
ENT Clinic
Fort Sill, OK 73503-4472
Phone (580) 558-2453

Other identifiers 1

IdentifierTypeStateIssuer
200048660 AMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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
I20090601000521 OK Practitioner - Nurse Practitioner 8325197999 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
ENT of Oklahoma PLLCGroup PAC ID 5799732236, 5 clinicians

Practice addresses (Care Compare)

5402 SW Lee Blvd
Lawton, OK 73505-9521
Phone (580) 531-0022

Hospital & facility affiliations

  • Memorial Health Hospital, Lawton, OK, CCN 370056

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
ENT of Oklahoma PLLC CurrentSince Jul 15, 2002 Accepting new patients
Summit Medical Center Past Accepting new patients
Jackson County Memorial Hospital Authority Past Accepting new patients

Locations

5402 SW Lee Blvd
Lawton, OK 73505
Phone (580) 531-0022

Organizations & group practices 3

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 3

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": "1117584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313452800000",
    "number": "1154323301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4301 WILSON ST",
            "address_2": "ENT CLINIC",
            "city": "FORT SILL",
            "state": "OK",
            "postal_code": "735034472",
            "telephone_number": "580-558-2453",
            "fax_number": "580-558-2427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4301 WILSON ST",
            "address_2": "ENT CLINIC",
            "city": "FORT SILL",
            "state": "OK",
            "postal_code": "735034472",
            "telephone_number": "580-558-2453",
            "fax_number": "580-558-2427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWAIN",
        "first_name": "BRENDA",
        "middle_name": "K",
        "credential": "A.R.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-01",
        "last_updated": "2011-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OK",
            "license": "R0033710",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200048660 A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Sill, OK

Sources for this page

Verify at the official NPI Registry.