Organization Active NPI

SWFL Integrative Medicine, P.a.

  • General Practice Physician
  • Fort Myers, FL
National Provider Identifier
1386265254
Registry record updated May 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
SWFL INTEGRATIVE MEDICINE, P.A.
Practice address
1570 Colonial Blvd Ste a
Fort Myers, FL 33907-1031
Phone
(239) 208-6676
NPI assigned
May 2, 2020
Last updated
May 2, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 2, 2020

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

Authorized official

Name
Dr. Heather V Auld, MDNPI 1396727178
Title
Owner
Phone
(239) 208-6676

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207V00000X
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X Primary

Addresses

Primary practice location

1570 Colonial Blvd Ste a
Fort Myers, FL 33907-1031

Mailing address

1570 Colonial Blvd Ste a
Fort Myers, FL 33907-1031
Phone (239) 208-6676

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230202000559 FL Part B Supplier - Clinic/Group Practice 0345612263 Receives reassigned benefits from 1 practitioner
Practice locations: Fort Myers, FL

National Provider Directory

National Provider Directory

Locations

1570 Colonial Blvd
Ste A
Fort Myers, FL 33907
Phone (239) 208-6676

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1588377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1588377600000",
    "number": "1386265254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1570 COLONIAL BLVD STE A",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339071031",
            "telephone_number": "239-208-6676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1570 COLONIAL BLVD STE A",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339071031",
            "telephone_number": "239-208-6676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SWFL INTEGRATIVE MEDICINE, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-02",
        "last_updated": "2020-05-02",
        "certification_date": "2020-05-02",
        "status": "A",
        "authorized_official_last_name": "AULD",
        "authorized_official_first_name": "HEATHER",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "239-208-6676",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.