Individual provider Active NPI

Deborah Lynn Swift, MD

  • Obstetrics Physician
  • Fairfield, CA
National Provider Identifier
1477660256
Registry record updated Jun 24, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics PhysicianTaxonomy code 207VX0000X
License
036093309 Issued in IL
Practice address
1860 Pennsylvania Ave
Suite 310
Fairfield, CA 94533-3590
Phone
(707) 646-4166
NPI assigned
Aug 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics Physician 207VX0000X 036093309 IL Primary

Addresses

Primary practice location

1860 Pennsylvania Ave
Suite 310
Fairfield, CA 94533-3590

Mailing address

PO Box 581777
Elk Grove, CA 95758-0030
Phone (847) 721-6887

Other identifiers 1

IdentifierTypeStateIssuer
036093309MedicaidIL

Other names 1

  • Dr. Deborah Lynn Wollard Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, FL2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20081126000145 CA Practitioner - Obstetrics/Gynecology 2264592955 Reassigns benefits to 1 organization
I20191004000370 FL Practitioner - Obstetrics/Gynecology 2264592955 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
DHP of Manatee PAGroup PAC ID 5799016846, 45 clinicians

Practice addresses (Care Compare)

901 45TH St
Mangonia Park, FL 33407-2413
Phone (561) 844-6300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036093309ILMDObstetrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
DHP of Manatee PA CurrentSince Sep 1, 2019 Accepting new patients
DHP of California Medical Group Inc CurrentSince Jul 1, 2016 Accepting new patients
DHP of Northbay Medical Group Inc Past Accepting new patients
Fairfield on-Call Specialists PC Past Accepting new patients
Central California Inpatient Physicians Past Accepting new patients

Locations

1600 W Avenue J
Lancaster, CA 93534
Phone (661) 726-6254

1800 N California St
Stockton, CA 95204
Phone (209) 467-6400

901 45th St
Mangonia Park, FL 33407
Phone (561) 844-6300

1901 SW 172nd Ave
Miramar, FL 33029
Phone (954) 276-5401

1500 SW 1st Ave
Ocala, FL 34471
Phone (352) 351-7500

703 N Flamingo Rd
Pembroke Pnes, FL 33028
Phone (954) 436-5000

101 Avenue O SE
Winter Haven, FL 33880
Phone (863) 294-7010

Organizations & group practices 5

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": "1156464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308873600000",
    "number": "1477660256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 581777",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957580030",
            "telephone_number": "847-721-6887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1860 PENNSYLVANIA AVE",
            "address_2": "SUITE 310",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945333590",
            "telephone_number": "707-646-4166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWIFT",
        "first_name": "DEBORAH",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-25",
        "last_updated": "2011-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VX0000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Obstetrics",
            "state": "IL",
            "license": "036093309",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036093309",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DEBORAH",
            "last_name": "WOLLARD",
            "middle_name": "LYNN",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fairfield, CA

Sources for this page

Verify at the official NPI Registry.