Active NPI
Edith Dawn Swaby-Ellis, M.D.
- Pediatrics Physician
- Chamblee, GA
National Provider Identifier
1639285463
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 029112
- Practice address
- 3807 Clairmont Road
North Dekalb Grady Clinic
Chamblee, GA 30341 - Phone
- (404) 616-0700
- Fax
- (404) 616-3078
- NPI assigned
- Aug 22, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 029112 | GA | Primary |
Addresses
Primary practice location
3807 Clairmont Road
North Dekalb Grady Clinic
Chamblee, GA 30341
Mailing address
4370 Apple Tree Dr
Stone Mountain
Stone Mountain, GA 30083-2467
Phone (404) 298-9388
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00331755A | Medicaid | GA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 029112 | GA | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Grady Memorial Hospital Corporation | Past | Accepting new patients |
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.
-
- General Acute Care Hospital
- Atlanta, GA
- NPI 1992799050
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156204800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1639285463",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4370 APPLE TREE DR",
"address_2": "STONE MOUNTAIN",
"city": "STONE MOUNTAIN",
"state": "GA",
"postal_code": "300832467",
"telephone_number": "404-298-9388"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3807 CLAIRMONT ROAD",
"address_2": "NORTH DEKALB GRADY CLINIC",
"city": "CHAMBLEE",
"state": "GA",
"postal_code": "30341",
"telephone_number": "404-616-0700",
"fax_number": "404-616-3078"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SWABY-ELLIS",
"first_name": "EDITH",
"middle_name": "DAWN",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-22",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "GA",
"license": "029112",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00331755A",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Chamblee, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.