Theodore Swann, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

23395 Issued in SC

Practice address

386 College Ave
Clemson, SC 29631-1475

Phone

(864) 654-2067

Fax

(864) 654-3261

NPI assigned

May 30, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Feb 27, 2014 through Feb 27, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Tiger Diagnostics Laboratory LLC

  • Clinical Medical Laboratory
  • Piedmont, SC
  • NPI 1356183875
  NPD Authorized official
• Anmed Health OB-GYN Associates

  • Obstetrics & Gynecology Physician
  • Clemson, SC
  • NPI 1447473715
  NPD (past)

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

{
    "created_epoch": "1148947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1272326400000",
    "number": "1225085699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "386 COLLEGE AVE",
            "city": "CLEMSON",
            "state": "SC",
            "postal_code": "296311432",
            "telephone_number": "864-654-2067",
            "fax_number": "864-654-3261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "386 COLLEGE AVE",
            "city": "CLEMSON",
            "state": "SC",
            "postal_code": "296311475",
            "telephone_number": "864-654-2067",
            "fax_number": "864-654-3261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWANN",
        "first_name": "THEODORE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-30",
        "last_updated": "2010-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "23395",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00362791",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "233955",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Douglas Kinly Sturkie III, PHD
• Alora Marie Sullivan, ATC
• Heather Summers, RD, LD
• Justin Henry Surratt, O.D.
• Susie C. Swann
• Kevin McKinley Tabb Jr.
• Thomas Henry Teasley, PHARMD
• Lindsey Pete Terbeek, DPT
• The Well Center
• Thekey of South Carolina, LLC

• Family Medicine Physician in Clemson, SC
• Providers in Clemson, SC by specialty
• Family Medicine Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2010; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.