Individual provider Active NPI

Gabriel Johanan Swinney

  • Nurse's Aide
  • Fayetteville, NC
National Provider Identifier
1245995968
Registry record updated Nov 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse's AideTaxonomy code 376K00000X
License
HC6304 Issued in NC
Practice address
1830 Owen Dr Ste 108
Fayetteville, NC 28304-3412
Phone
(910) 779-0050
Fax
(910) 779-0199
NPI assigned
Nov 8, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse's Aide 376K00000X HC6304 NC Primary

Addresses

Primary practice location

1830 Owen Dr Ste 108
Fayetteville, NC 28304-3412

Mailing address

PO Box 64456
Fayetteville, NC 28306-0456
Phone (910) 779-0050

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

LicenseStateTypeSpecialty
HC6304NCMDNurse's Aide

Practice roles

OrganizationSpecialtyStatusNew patients
A Gracious Touch Home Care Agency CurrentSince Nov 21, 2021 Accepting new patients

Locations

1830 Owen Dr
Ste 108
Fayetteville, NC 28304
Phone (910) 584-8305

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1636329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636329600000",
    "number": "1245995968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 64456",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283060456",
            "telephone_number": "910-779-0050",
            "fax_number": "910-779-0199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1830 OWEN DR STE 108",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283043412",
            "telephone_number": "910-779-0050",
            "fax_number": "910-779-0199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWINNEY",
        "first_name": "GABRIEL",
        "middle_name": "JOHANAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-11-08",
        "last_updated": "2021-11-08",
        "certification_date": "2021-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": "NC",
            "license": "HC6304",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.