Individual provider Active NPI

Cornelia H. Swayze, LCSW, BCD

  • Clinical Social Worker
  • Diamondhead, MS
National Provider Identifier
1356445944
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C4648 Issued in MS
Practice address
4387 Leisure Time Drive
Diamondhead, MS 39525
Phone
(228) 363-2211
Fax
(228) 255-6494
NPI assigned
Sep 12, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X C4648 MS Primary

Addresses

Primary practice location

4387 Leisure Time Drive
Diamondhead, MS 39525

Mailing address

7619 Fairway Drive
Diamondhead, MS 39525-3436
Phone (228) 363-2211

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051205000109 MS Practitioner - Clinical Social Worker 5698795755 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4423 Leisure Time Dr
Unit C
Diamondhead, MS 39525-3261
Phone (228) 363-2211

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C4648MSMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Cornelia Swayze, LCSW, LLC CurrentSince Sep 26, 2001 Accepting new patients

Locations

4423 Leisure Time Dr
Diamondhead, MS 39525
Phone (228) 216-0130

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": "1158019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1356445944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7619 FAIRWAY DRIVE",
            "city": "DIAMONDHEAD",
            "state": "MS",
            "postal_code": "395253436",
            "telephone_number": "228-363-2211",
            "fax_number": "228-255-6494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4387 LEISURE TIME DRIVE",
            "city": "DIAMONDHEAD",
            "state": "MS",
            "postal_code": "39525",
            "telephone_number": "228-363-2211",
            "fax_number": "228-255-6494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWAYZE",
        "first_name": "CORNELIA",
        "middle_name": "H.",
        "name_prefix": "Mrs.",
        "credential": "LCSW, BCD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MS",
            "license": "C4648",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Diamondhead, MS

Sources for this page

Verify at the official NPI Registry.