Staci H Swan

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

AP60408810 Issued in WA

Practice address

1600 116TH Ave NE Ste 304
Bellevue, WA 98004-3057

Phone

(225) 715-5242

NPI assigned

Aug 19, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: staci.swan.2@30858.direct.athenahealth.com

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.

• Shine Pediatrics, PLLC

  • Pediatric Nurse Practitioner
  • Bellevue, WA
  • NPI 1821851239

  Pediatrics

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1376870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722988800000",
    "number": "1235562711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3509 184TH PL SE",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980128846",
            "telephone_number": "225-715-5242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 116TH AVE NE STE 304",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980043057",
            "telephone_number": "225-715-5242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWAN",
        "first_name": "STACI",
        "middle_name": "H",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-19",
        "last_updated": "2024-08-07",
        "certification_date": "2024-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "WA",
            "license": "AP60408810",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Suzzanne Myer Consulting LLC
• Charlotte Ruth Svenson, MSW ACSW
• Heidi Robin Swailes, M.C.
• Monalee Diane Swale, PHARMD
• Megan A Swan, PHD
• Swanson & Ericksen PLLC
• Chelsey Swanson, OTD
• Heather Swanson, PH.D.
• Kris Kevin Swanson, DDS
• Megan Noel Swanson, MOT, OTR/L, CHT

• Pediatric Nurse Practitioner in Bellevue, WA
• Providers in Bellevue, WA by specialty
• Pediatric Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2024; 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.