Individual provider Active NPI

Susan Marie Swift, PMHNP

  • Nurse Practitioner
  • Indio, CA
National Provider Identifier
1750565438
Registry record updated Mar 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
106370 Issued in AK
Practice address
47915 Oasis St
Indio, CA 92201-6950
Phone
(760) 863-8600
NPI assigned
Dec 18, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 20090027NP OR
Nurse Practitioner 363L00000X 20090027NP OR
Nurse Practitioner 363L00000X 106370 AK Primary

Addresses

Primary practice location

47915 Oasis St
Indio, CA 92201-6950

Mailing address

51048 Goldwater CT
Indio, CA 92201-9521
Phone (713) 203-4033

Other identifiers 2

IdentifierTypeStateIssuer
500632292MedicaidOR
500637379MedicaidOR

Other names 1

  • Susan Marie Bankston Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110825000536 OR Practitioner - Nurse Practitioner 2668552357 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
20090027NPORMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
DHS/Office of Financial Services Irs/Eopc/BMRC/Eotc/Osh/Osh-P CurrentSince Mar 1, 2020 Accepting new patients

Locations

2600 Center St NE
Salem, OR 97301
Phone (503) 945-2800

Interoperability endpoints

  • Direct secure messaging: sswift205540@direct.peacehealth.org

Organizations & group practices 1

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": "1197936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741219200000",
    "number": "1750565438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51048 GOLDWATER CT",
            "city": "INDIO",
            "state": "CA",
            "postal_code": "922019521",
            "telephone_number": "713-203-4033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47915 OASIS ST",
            "city": "INDIO",
            "state": "CA",
            "postal_code": "922016950",
            "telephone_number": "760-863-8600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWIFT",
        "first_name": "SUSAN",
        "middle_name": "MARIE",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-18",
        "last_updated": "2025-03-06",
        "certification_date": "2025-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "20090027NP",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OR",
            "license": "20090027NP",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AK",
            "license": "106370",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500632292",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500637379",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUSAN",
            "last_name": "BANKSTON",
            "middle_name": "MARIE",
            "credential": "PMHNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Indio, CA

Sources for this page

Verify at the official NPI Registry.