Individual provider Active NPI

Ansley Swann, PA-C, ATC

  • Physician Assistant
  • Raleigh, NC
National Provider Identifier
1336793330
Registry record updated Mar 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-16224 Issued in NC
Practice address
11221 Galleria Ave Ste 101
Raleigh, NC 27614-8137
Phone
(919) 562-9410
NPI assigned
Jul 29, 2019
Reactivated
Mar 23, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0010-16224 NC Primary
Athletic Trainer 2255A2300X LAT-5840 NC

Addresses

Primary practice location

11221 Galleria Ave Ste 101
Raleigh, NC 27614-8137

Mailing address

1243 Patrick Cir Apt B
Cary, NC 27511-4929
Phone (704) 989-1856

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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

Enrollment IDStateProvider typePAC IDDetails
I20260421000749 NC Practitioner - Physician Assistant 2365918935 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of North Carolina at Chapel Hill School of Medicine, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

11221 Galleria Ave
Suite 101
Raleigh, NC 27614-8137

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LAT-5840NCMDAthletic Trainer
0010-16224NCMDPhysician Assistant

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": "1564358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774224000000",
    "number": "1336793330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1243 PATRICK CIR APT B",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275114929",
            "telephone_number": "704-989-1856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11221 GALLERIA AVE STE 101",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276148137",
            "telephone_number": "919-562-9410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWANN",
        "first_name": "ANSLEY",
        "credential": "PA-C, ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-29",
        "last_updated": "2026-03-23",
        "certification_date": "2026-03-23",
        "deactivation_date": "2026-02-25",
        "reactivation_date": "2026-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-16224",
            "primary": true
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NC",
            "license": "LAT-5840",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.