Active NPI
Inna Swann, PHYSICAL THERAPIST
- Physical Therapist
- Hattiesburg, MS
National Provider Identifier
1205991064
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 4451
- Practice address
- 7 Willow Bend Dr
Hattiesburg, MS 39402-8552 - Phone
- (501) 908-5216
- NPI assigned
- Dec 22, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT2564 | AR | |
| Physical Therapist | 225100000X | 4451 | MS | Primary |
Addresses
Primary practice location
7 Willow Bend Dr
Hattiesburg, MS 39402-8552
Mailing address
7 Willow Bend Dr
Hattiesburg, MS 39402-8552
Phone (501) 908-5216
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 145581721 | Medicaid | AR | |
| 5X297 | Other | AR | BLUE CROSS BLUE SHIELD |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT2564 | AR | MD | Physical Therapist |
| 4451 | MS | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166745600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1231286400000",
"number": "1205991064",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7 WILLOW BEND DR",
"city": "HATTIESBURG",
"state": "MS",
"postal_code": "394028552",
"telephone_number": "501-908-5216"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7 WILLOW BEND DR",
"city": "HATTIESBURG",
"state": "MS",
"postal_code": "394028552",
"telephone_number": "501-908-5216"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SWANN",
"first_name": "INNA",
"credential": "PHYSICAL THERAPIST",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-12-22",
"last_updated": "2009-01-07",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "AR",
"license": "PT2564",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MS",
"license": "4451",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "145581721",
"state": "AR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "5X297",
"state": "AR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Hattiesburg, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.