Individual provider Active NPI

Roberta G Swain, M.D.

  • Dermatology Physician
  • Mobile, AL
National Provider Identifier
1700826443
Registry record updated Oct 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
23693 Issued in AL
Practice address
4300 Old Shell Rd Ste B
Mobile, AL 36608-2036
Phone
(251) 342-7880
Fax
(251) 342-8369
NPI assigned
Jun 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 23693 AL Primary

Addresses

Primary practice location

4300 Old Shell Rd Ste B
Mobile, AL 36608-2036

Mailing address

4300 Old Shell Rd Ste B
Mobile, AL 36608-2036
Phone (251) 342-7880

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20090121000387 AL Practitioner - Dermatology 8628132537 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of Alabama School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of South Alabama Health Care AuthorityGroup PAC ID 4082986088, 80 clinicians

Practice addresses (Care Compare)

4300 Old Shell Rd
Mobile, AL 36608-2048
Phone (251) 342-7880

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision11
Removal of skin lesions164
Skin biopsy370

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
23693ALMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of South Alabama Health Care Authority CurrentSince Jul 1, 2020 Accepting new patients
Springhill Dermatology Clinic, PC Dermatology CurrentSince Oct 10, 2021 Accepting new patients
University of South Alabama Health Care Authority Dermatology PastSince Oct 10, 2021 Accepting new patients

Locations

4300 Old Shell Rd
Ste B
Mobile, AL 36608
Phone (251) 342-7880

6701 Airport Blvd
Ste A101
Mobile, AL 36608
Phone (251) 633-8880

2423 Schillinger Rd S
Mobile, AL 36695
Phone (251) 660-5950

4300 Old Shell Rd
Mobile, AL 36608
Phone (251) 342-7880

6701 Airport Blvd
#A1
Mobile, AL 36608
Phone (251) 633-8880

Interoperability endpoints

  • Direct secure messaging: roberta.swain.1@16253.direct.athenahealth.com

Organizations & group practices 3

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": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633478400000",
    "number": "1700826443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4300 OLD SHELL RD STE B",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366082036",
            "telephone_number": "251-342-7880",
            "fax_number": "251-342-8369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4300 OLD SHELL RD STE B",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366082036",
            "telephone_number": "251-342-7880",
            "fax_number": "251-342-8369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWAIN",
        "first_name": "ROBERTA",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-08",
        "last_updated": "2021-10-06",
        "certification_date": "2021-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "AL",
            "license": "23693",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mobile, AL

Sources for this page

Verify at the official NPI Registry.