SWC Ruston, LLC

Primary specialty

Gynecology PhysicianTaxonomy code 207VG0400X

License

MD.201086 Issued in LA

Legal business name

SWC RUSTON, LLC

Practice address

1809 Northpointe LN
Suite 103
Ruston, LA 71270-3853

Phone

(318) 255-3223

Fax

(318) 255-3181

NPI assigned

Jul 31, 2012

Organization subpart

No

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

Authorized official

Name

Nathan Wayne Goodyear, M.D.

Title

Medical Doctor

Phone

(318) 255-3223

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

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

{
    "created_epoch": "1343692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1343692800000",
    "number": "1295081909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1809 NORTHPOINTE LN",
            "address_2": "SUITE 103",
            "city": "RUSTON",
            "state": "LA",
            "postal_code": "712703853",
            "telephone_number": "318-255-3223",
            "fax_number": "318-255-3181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1809 NORTHPOINTE LN",
            "address_2": "SUITE 103",
            "city": "RUSTON",
            "state": "LA",
            "postal_code": "712703853",
            "telephone_number": "318-255-3223",
            "fax_number": "318-255-3181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SWC RUSTON, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-31",
        "last_updated": "2012-07-31",
        "status": "A",
        "authorized_official_last_name": "GOODYEAR",
        "authorized_official_first_name": "NATHAN",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "MEDICAL DOCTOR",
        "authorized_official_telephone_number": "318-255-3223",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "LA",
            "license": "MD.201086",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1453331",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1538166970",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE MEDICAL LICENSE",
            "identifier": "MD.201086",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Melissa Sullivan, NP
• Wanda J Sullivan, RN
• Whitney Sumlin
• Brooke Nichole Sutton, NP
• Dustin Swafford
• Daniel Takata, ATC
• Martina Abena Tamakloe, MD
• Sedo Tamakloe, MD
• James Patrick Taylor, M.D.
• Kaitlyn Taylor, LPC

• All providers in Ruston, LA
• Gynecology Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2012; 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.