Active NPI
Swansboro Medical Center, PA
- Family Medicine Physician
- Swansboro, NC
National Provider Identifier
1740317197
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 66693
- Legal business name
- SWANSBORO MEDICAL CENTER, PA
- Practice address
- 718 W Corbett Ave
Swansboro, NC 28584-8452 - Phone
- (910) 326-5588
- Fax
- (910) 326-6923
- NPI assigned
- Feb 27, 2007
- Last updated
- Aug 22, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Dennis Michael Mahan, M.D.
- Title
- Clinic Director
- Phone
- (910) 326-5588
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 66693 | NC | Primary |
Addresses
Primary practice location
718 W Corbett Ave
Swansboro, NC 28584-8452
Mailing address
718 W Corbett Ave
Swansboro, NC 28584-8452
Phone (910) 326-5588
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2804615 | Other | NC | CIGNA MEDICARE |
| 0130R | Other | NC | BCBSNC |
| 343972A | Medicaid | NC | |
| E0124 | Other | NC | MEDCOST |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172534400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1740317197",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "718 W CORBETT AVE",
"city": "SWANSBORO",
"state": "NC",
"postal_code": "285848452",
"telephone_number": "910-326-5588",
"fax_number": "910-326-6923"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "718 W CORBETT AVE",
"city": "SWANSBORO",
"state": "NC",
"postal_code": "285848452",
"telephone_number": "910-326-5588",
"fax_number": "910-326-6923"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SWANSBORO MEDICAL CENTER, PA",
"organizational_subpart": "NO",
"enumeration_date": "2007-02-27",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "MAHAN",
"authorized_official_first_name": "DENNIS",
"authorized_official_middle_name": "MICHAEL",
"authorized_official_title_or_position": "CLINIC DIRECTOR",
"authorized_official_telephone_number": "910-326-5588",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NC",
"license": "66693",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA MEDICARE",
"identifier": "2804615",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBSNC",
"identifier": "0130R",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "343972A",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDCOST",
"identifier": "E0124",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Swansboro, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.