Individual provider Active NPI

Allen Cecil Swan, MD

  • General Practice Physician
  • Savannah, GA
National Provider Identifier
1699775676
Registry record updated Sep 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
01054685A Issued in IN
Practice address
230 Duncan Dr
BLDG 1440, Ste A148
Savannah, GA 31409-5107
Phone
(912) 315-5818
Fax
(912) 315-5043
NPI assigned
Jul 29, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 01054685A IN Primary
Adult Medicine Physician 207QA0505X 01054685A IN

Addresses

Primary practice location

230 Duncan Dr
BLDG 1440, Ste A148
Savannah, GA 31409-5107

Mailing address

230 Duncan Dr
BLDG 1440, Ste A148
Savannah, GA 31409-5107
Phone (912) 315-5818

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20160425001122 GA Order and Referring Only - General PracticePractitioner - General Practice 1850574211

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
University of Miami, LM Miller School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Effingham Rehab Services, LLCGroup PAC ID 5597752063, shared by 3 NPIs, 143 clinicians

Practice addresses (Care Compare)

123 Canal St
Suite 203
Pooler, GA 31322-4104
Phone (912) 988-1283

National Provider Directory

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

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1122595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1284595200000",
    "number": "1699775676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 DUNCAN DR",
            "address_2": "BLDG 1440, STE A148",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314095107",
            "telephone_number": "912-315-5818",
            "fax_number": "912-315-5043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 DUNCAN DR",
            "address_2": "BLDG 1440, STE A148",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314095107",
            "telephone_number": "912-315-5818",
            "fax_number": "912-315-5043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWAN",
        "first_name": "ALLEN",
        "middle_name": "CECIL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-29",
        "last_updated": "2010-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "IN",
            "license": "01054685A",
            "primary": true
        },
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "IN",
            "license": "01054685A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Savannah, GA

Sources for this page

Verify at the official NPI Registry.