Active NPI
Kimberly Dawn Swanner, DNP, AGACNP-BC
- Acute Care Nurse Practitioner
- Memphis, TN
National Provider Identifier
1164057865
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acute Care Nurse Practitioner
- License
- 32091
- Practice address
- 877 Jefferson Ave
Memphis, TN 38103-2807 - Phone
- (901) 545-7100
- NPI assigned
- Mar 3, 2020
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 880120 | MS | |
| Acute Care Nurse Practitioner | 363LA2100X | 905370 | MS | |
| Acute Care Nurse Practitioner | 363LA2100X | 32091 | TN | Primary |
Addresses
Primary practice location
877 Jefferson Ave
Memphis, TN 38103-2807
Mailing address
5879 Highway 315
Water Valley, MS 38965-3043
Phone (662) 607-7077
Other practice location 1
504 Azalea Dr Ste A
Oxford, MS 38655-5397
Phone (662) 636-4320
Other practice location 2
504 Azalea Dr Ste A
Oxford, MS 38655-5397
Phone (662) 636-4320
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN, MS
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care CompareMerit-based Incentive Payment System (MIPS)
- Final score
- 80.97 of 100
- Quality
- 64.58
- Improvement activities
- 40
- Cost
- 77.33
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 880120 | MS | MD | Registered Nurse |
| 905370 | MS | MD | Acute Care Nurse Practitioner |
| 32091 | TN | MD | Acute Care Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Relias Emergency Medicine Specialists of Amory, LLC | Current | Accepting new patients | |
| Relias Hospitalist Medicine Specialists of Amory LLC | Current | Accepting new patients | |
| Relias Clinical Decision Specialists of Hattiesburg, LLC | Current | Accepting new patients |
Locations
1105 Earl Frye Blvd
Amory, MS 38821
Phone (662) 256-7111
6051 U S Highway 49
Hattiesburg, MS 39401
Phone (601) 288-2690
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.
-
- Emergency Medicine Physician
- Hattiesburg, MS
- NPI 1336867415
-
- Emergency Medicine Physician
- Amory, MS
- NPI 1265074769
-
- Hospitalist Physician
- Amory, MS
- NPI 1205470796
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1583193600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1666742400000",
"number": "1164057865",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5879 HIGHWAY 315",
"city": "WATER VALLEY",
"state": "MS",
"postal_code": "389653043",
"telephone_number": "662-607-7077"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "877 JEFFERSON AVE",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381032807",
"telephone_number": "901-545-7100"
}
],
"practiceLocations": [
{
"address_1": "504 Azalea Dr Ste A",
"address_purpose": "LOCATION",
"city": "Oxford",
"state": "MS",
"postal_code": "386555397",
"country_code": "US",
"telephone_number": "662-636-4320",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "504 Azalea Dr Ste A",
"address_purpose": "LOCATION",
"city": "Oxford",
"state": "MS",
"postal_code": "386555397",
"country_code": "US",
"telephone_number": "662-636-4320",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SWANNER",
"first_name": "KIMBERLY",
"middle_name": "DAWN",
"name_prefix": "Dr.",
"credential": "DNP, AGACNP-BC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-03-03",
"last_updated": "2022-10-26",
"certification_date": "2022-10-26",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "MS",
"license": "880120",
"primary": false
},
{
"code": "363LA2100X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Acute Care",
"state": "MS",
"license": "905370",
"primary": false
},
{
"code": "363LA2100X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Acute Care",
"state": "TN",
"license": "32091",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Memphis, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.