Active NPI
Benjamin Swafford
- Athletic Trainer
- Douglas, GA
National Provider Identifier
1215330279
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- AT000633
- Practice address
- 159 Trojan Way
Douglas, GA 31533-8263 - Phone
- (912) 393-6633
- NPI assigned
- Oct 6, 2014
- Last updated
- Oct 6, 2014
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | AT000633 | GA | Primary |
Addresses
Primary practice location
159 Trojan Way
Douglas, GA 31533-8263
Mailing address
1691 Curtis Vickers Rd
Ambrose, GA 31512-3022
Phone (912) 592-6435
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 |
|---|---|---|---|
| AT000633 | GA | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1412553600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1412553600000",
"number": "1215330279",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1691 CURTIS VICKERS RD",
"city": "AMBROSE",
"state": "GA",
"postal_code": "315123022",
"telephone_number": "912-592-6435",
"fax_number": "912-720-1009"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "159 TROJAN WAY",
"city": "DOUGLAS",
"state": "GA",
"postal_code": "315338263",
"telephone_number": "912-393-6633"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SWAFFORD",
"first_name": "BENJAMIN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-10-06",
"last_updated": "2014-10-06",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "GA",
"license": "AT000633",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Douglas, GA
- Wycliff Harold Stewart, DC
- Regina Ann Stone, FNP-C
- Rebecca Lynn Michelle Strickland, MHC-LP, APC
- Jeffery Todd Stringer, LCSW
- Tonya Lee Sumner, FNP-C
- Swain Drug Company LLC (Swain's Pharmacy)
- Swain Drug Company LLC (Swain's Long-Term Care Pharmacy)
- Jared William Swain, PHARMD
- Alyssa Taft, FNP-C
- Tanner Optical, Inc. (Murphy Eye Center)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.