Mark Gregory Swedenburg, MD

Primary specialty

Aerospace Medicine PhysicianTaxonomy code 2083A0100X

License

200200290 Issued in NC

Practice address

400 Old Smithfield Rd
Goldsboro, NC 27530-8464

Phone

(919) 581-4660

NPI assigned

Nov 29, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: mswedenburg476006@direct.unc.nchie.net

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453420800000",
    "number": "1164599015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "218 WALNUT CREEK DR",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275348980",
            "telephone_number": "919-751-2086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 OLD SMITHFIELD RD",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275308464",
            "telephone_number": "919-581-4660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWEDENBURG",
        "first_name": "MARK",
        "middle_name": "GREGORY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-29",
        "last_updated": "2016-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083A0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Aerospace Medicine",
            "state": "NC",
            "license": "200200290",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "200200290",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3406028",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Swanville Dialysis, LLC
• Rita Sweet
• Misha Monette Sykes
• Synergy Wellness Clinic, PLLC
• T Gibson Blackman
• Wilson Egbe Tabe, MD

• Aerospace Medicine Physician in Goldsboro, NC
• Providers in Goldsboro, NC by specialty
• Aerospace Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2016; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.