NPIMap

Organization Active NPI

Swan Dermatology Center, PC

  • Dermatology Physician
  • Lafayette, IN
National Provider Identifier
1194757518
Registry record updated May 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
01042461 Issued in IN
Legal business name
SWAN DERMATOLOGY CENTER, PC
Practice address
2020 Union St., Suite 300
Lafayette, IN 47904
Phone
(765) 446-0282
Fax
(765) 446-8299
NPI assigned
Jul 7, 2006
Last updated
May 16, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 16, 2008

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

Authorized official

Name
Lori Siegert Swan, MDNPI 1518044601
Title
President
Phone
(765) 446-0282

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 01042461 IN Primary

Addresses

Primary practice location

2020 Union St., Suite 300
Lafayette, IN 47904

Mailing address

2020 Union St., Suite 300
Lafayette, IN 47904
Phone (765) 446-0282

Other identifiers 1

IdentifierTypeStateIssuer
CE9089OtherINRR MEDICARE

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210896000000",
    "number": "1194757518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2020 UNION ST., SUITE 300",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "47904",
            "telephone_number": "765-446-0282",
            "fax_number": "765-446-8299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 UNION ST., SUITE 300",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "47904",
            "telephone_number": "765-446-0282",
            "fax_number": "765-446-8299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SWAN DERMATOLOGY CENTER, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-07",
        "last_updated": "2008-05-16",
        "status": "A",
        "authorized_official_last_name": "SWAN",
        "authorized_official_first_name": "LORI",
        "authorized_official_middle_name": "SIEGERT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "765-446-0282",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "IN",
            "license": "01042461",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "CE9089",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.