Individual provider Active NPI

Theresa Marie Swift, C.R.N.A.

  • Certified Registered Nurse Anesthetist
  • Champaign, IL
National Provider Identifier
1669454740
Registry record updated Jul 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
ARNP9271688 Issued in FL
Practice address
2001 N Mattis Ave Unit 7230
Champaign, IL 61826-0991
Phone
(217) 840-1419
NPI assigned
Nov 15, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 2, 2013

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 209-000388 IL
Registered Nurse 163W00000X 28150300A IN
Registered Nurse 163W00000X 9271688 FL
Registered Nurse 163W00000X 574749 TX
Registered Nurse 163W00000X 3007658 KY
Certified Registered Nurse Anesthetist 367500000X ARNP9271688 FL Primary

Addresses

Primary practice location

2001 N Mattis Ave Unit 7230
Champaign, IL 61826-0991

Mailing address

2001 N Mattis Ave Unit 7230
Champaign, IL 61826-0991
Phone (217) 840-1419

Other identifiers 7

IdentifierTypeStateIssuer
371390028001OtherILTRICARE GROUP ID NO.
216564000OtherILWORKMAN'S COMP GROUP ID
430068235OtherILRR MEDICARE PIN
CG3273OtherILRR MEDICARE GROUP ID NO.
GV765YOtherFLMEDICARE PTAN
09223524OtherILBC/BS GROUP ID NO.
008321200MedicaidFL

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
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
9271688FLMDRegistered Nurse
28150300AINMDRegistered Nurse
3007658KYMDRegistered Nurse
574749TXMDRegistered Nurse
209-000388ILMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Marion Hospital Corporation Nurse Anesthetist, Certified Registered Past Accepting new patients
Vigilant Anesthesia Inc Nurse Anesthetist, Certified Registered Past Accepting new patients

Organizations & group practices 2

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": "1132012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372723200000",
    "number": "1669454740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 N MATTIS AVE UNIT 7230",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618260991",
            "telephone_number": "217-840-1419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 N MATTIS AVE UNIT 7230",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618260991",
            "telephone_number": "217-840-1419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWIFT",
        "first_name": "THERESA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "C.R.N.A.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-11-15",
        "last_updated": "2013-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IL",
            "license": "209-000388",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IN",
            "license": "28150300A",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "9271688",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "574749",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "KY",
            "license": "3007658",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "ARNP9271688",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE GROUP ID NO.",
            "identifier": "371390028001",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WORKMAN'S COMP GROUP ID",
            "identifier": "216564000",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE PIN",
            "identifier": "430068235",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE GROUP ID NO.",
            "identifier": "CG3273",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "GV765Y",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS GROUP ID NO.",
            "identifier": "09223524",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008321200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Champaign, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.