Active NPI
Gwynn D Swallows, PA-C
- Emergency Medicine Physician
- Chattanooga, TN
National Provider Identifier
1649208299
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- PA0407
- Practice address
- 2525 Desales Avenue
Chattanooga, TN 37404 - Phone
- (423) 697-0014
- Fax
- (423) 648-6280
- NPI assigned
- Jun 30, 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acute Care Nurse Practitioner | 363LA2100X | PA00407 | TN | |
| Emergency Medicine Physician | 207P00000X | PA0407 | TN | Primary |
Addresses
Primary practice location
2525 Desales Avenue
Chattanooga, TN 37404
Mailing address
725 Glenwood Drive,
Suite E-487
Chattanooga, TN 37404
Phone (423) 697-0014
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 189041088B | Medicaid | GA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN, GA, AK
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 3
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20071205000524 | TN | Practitioner - Physician Assistant | 9638268188 | Reassigns benefits to 1 organization |
| I20210323001626 | GA | Practitioner - Physician Assistant | 9638268188 | Reassigns benefits to 1 organization |
| I20250108000719 | AK | Practitioner - Physician Assistant | 9638268188 | Reassigns benefits to 1 organization |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2799 | GA | MD | Clinical Psychologist |
| PA0407 | TN | MD | Emergency Medicine Physician |
| PA00407 | TN | MD | Acute Care Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Chattanooga Emergency Medicine PLLC | Current | Accepting new patients | |
| Norton Sound Health Corporation | Current | Accepting new patients | |
| Norton Sound Health Corporation | Current | Accepting new patients | |
| University Health System Inc | Past | Accepting new patients | |
| Emergency Medical Associates | Past | Accepting new patients | |
| Emergency Medical Associates | Past | Accepting new patients | |
| Southeastern Emergency Services P C | Past | Accepting new patients |
Locations
2525 Desales Ave
Chattanooga, TN 37404
Phone (423) 495-2620
725 Glenwood Dr
Ste E487
Chattanooga, TN 37404
Phone (423) 697-0014
Organizations & group practices 8
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.
-
- Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
- Nome, AK
- NPI 1427187046
-
- Emergency Care Clinic/Center
- Hixson, TN
- NPI 1457381857
-
- Emergency Care Clinic/Center
- Chattanooga, TN
- NPI 1982645396
-
- Nurse Practitioner
- Athens, TN
- NPI 1669414264
-
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
- Knoxville, TN
- NPI 1306609748
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151625600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1321574400000",
"number": "1649208299",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "725 GLENWOOD DRIVE,",
"address_2": "SUITE E-487",
"city": "CHATTANOOGA",
"state": "TN",
"postal_code": "37404",
"telephone_number": "423-697-0014",
"fax_number": "423-648-6280"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2525 DESALES AVENUE",
"city": "CHATTANOOGA",
"state": "TN",
"postal_code": "37404",
"telephone_number": "423-697-0014",
"fax_number": "423-648-6280"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SWALLOWS",
"first_name": "GWYNN",
"middle_name": "D",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-30",
"last_updated": "2011-11-18",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2100X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Acute Care",
"state": "TN",
"license": "PA00407",
"primary": false
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "TN",
"license": "PA0407",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "189041088B",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Chattanooga, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.