Active NPI
Vanessa Rose Swickline, ATC
- Athletic Trainer
- Indianapolis, IN
National Provider Identifier
1639455181
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- RT004502
- Practice address
- 5949 W Raymond St
Indianapolis, IN 46241-4348 - Phone
- (317) 390-5590
- Fax
- (317) 486-2194
- NPI assigned
- Oct 28, 2011
- 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 |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | RT004502 | PA | Primary |
Addresses
Primary practice location
5949 W Raymond St
Indianapolis, IN 46241-4348
Mailing address
5949 W Raymond St
Indianapolis, IN 46241-4348
Phone (630) 296-2222
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RT004502 | PA | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1319760000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1439683200000",
"number": "1639455181",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5949 W RAYMOND ST",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462414348",
"telephone_number": "630-296-2222",
"fax_number": "630-759-6152"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5949 W RAYMOND ST",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462414348",
"telephone_number": "317-390-5590",
"fax_number": "317-486-2194"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SWICKLINE",
"first_name": "VANESSA",
"middle_name": "ROSE",
"name_prefix": "Ms.",
"credential": "ATC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-10-28",
"last_updated": "2015-08-16",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "PA",
"license": "RT004502",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.