Active NPI
Swan Health & Wellness LLC
- Primary Care Nurse Practitioner
- Waco, TX
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Primary Care Nurse Practitioner
- Legal business name
- SWAN HEALTH & WELLNESS LLC
- Practice address
- 1174 Idlewood Dr
Waco, TX 76705-5238 - Phone
- (254) 214-2558
- NPI assigned
- Jan 3, 2019
- Last updated
- Jun 15, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Chandra Montgomery
- Title
- Managing Member
- Phone
- (254) 214-2558
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Nurse Practitioner | 363LP2300X | Primary |
Addresses
Primary practice location
1174 Idlewood Dr
Waco, TX 76705-5238
Mailing address
1174 Idlewood Dr
Waco, TX 76705-5238
Other practice location 1
1302 E Elm St
Hillsboro, TX 76645-2646
Phone (254) 214-2558
National Provider Directory
National Provider DirectoryOwnership & related parties
Subparts reporting this organization as parent 1
Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.
-
dba Affirm At Home Care Solutions
- In Home Supportive Care Agency
- Waco, TX
- NPI 1508514084
Practitioners & affiliated clinicians
Practitioners 1
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.
-
- Adult Health Nurse Practitioner
- Waco, TX
- NPI 1124186507
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1546473600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1592179200000",
"number": "1245703149",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1174 IDLEWOOD DR",
"city": "WACO",
"state": "TX",
"postal_code": "767055238"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1174 IDLEWOOD DR",
"city": "WACO",
"state": "TX",
"postal_code": "767055238",
"telephone_number": "254-214-2558"
}
],
"practiceLocations": [
{
"address_1": "1302 E Elm St",
"address_purpose": "LOCATION",
"city": "Hillsboro",
"state": "TX",
"postal_code": "766452646",
"country_code": "US",
"telephone_number": "254-214-2558",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "SWAN HEALTH & WELLNESS LLC",
"organizational_subpart": "NO",
"enumeration_date": "2019-01-03",
"last_updated": "2020-06-15",
"certification_date": "2020-06-15",
"status": "A",
"authorized_official_last_name": "MONTGOMERY",
"authorized_official_first_name": "CHANDRA",
"authorized_official_title_or_position": "MANAGING MEMBER",
"authorized_official_telephone_number": "254-214-2558"
},
"taxonomies": [
{
"code": "363LP2300X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner, Primary Care",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Waco, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.