Russell E Swann M.D. PA

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

E5626 Issued in TX

Legal business name

RUSSELL E SWANN M.D. PA

Doing business as

Brazos Eye Surgery of Texas

Practice address

201 Londonderry Dr
Waco, TX 76712-7902

Phone

(254) 772-4499

Fax

(254) 772-4436

NPI assigned

Dec 5, 2007

Last updated

Oct 23, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Shaye J Wooten

Title

Insurance Billing

Phone

(254) 772-4499

Specialties & licenses 1

Addresses

Other identifiers 6

Other names 1

• BRAZOS EYE SURGERY OF TEXAS Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 3

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.

• Forrest Beau Swann, MD

  • Cornea and External Diseases Specialist Physician
  • Waco, TX
  • NPI 1407291420

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Jordan Tanous, OD

  • Optometrist
  • Waco, TX
  • NPI 1801313382
  Medicare reassignment Care Compare group NPD
• Alexandria Schickner, D.C.

  • Rehabilitation Chiropractor
  • Woodway, TX
  • NPI 1427582931
  NPD

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

{
    "created_epoch": "1196812800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350950400000",
    "number": "1285816850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 LONDONDERRY DR",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767127902",
            "telephone_number": "254-772-4499",
            "fax_number": "254-772-4436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 LONDONDERRY DR",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767127902",
            "telephone_number": "254-772-4499",
            "fax_number": "254-772-4436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUSSELL E SWANN M.D. PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-05",
        "last_updated": "2012-10-23",
        "status": "A",
        "authorized_official_last_name": "WOOTEN",
        "authorized_official_first_name": "SHAYE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "INSURANCE BILLING",
        "authorized_official_telephone_number": "254-772-4499"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "TX",
            "license": "E5626",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "085656902",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE PIN",
            "identifier": "DC9834",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1477717759",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1841293016",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1073518072",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1619130895",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BRAZOS EYE SURGERY OF TEXAS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Royal Manor II
• Royal West Senior Care, LLC (Royal Manor West)
• Rachel Rube, DO
• Meghan Marie Ruscitto, PA-C
• Elizabeth Antle Rushing, FNP
• Halle Tamsen Russell, ATC
• Jennifer Russell, COTA
• Joan Hannah Russell, MSN, RN, NP-C
• Rustic Trails LLC
• Mark Allen Rutledge, APN

• Ophthalmology Physician in Waco, TX
• Providers in Waco, TX by specialty
• Ophthalmology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.