Individual provider Active NPI

Jean E Swearingen, MD

  • Family Medicine Physician
  • Maryville, IL
National Provider Identifier
1760442198
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036085861 Issued in IL
Practice address
6810 State Route 162
Box 215
Maryville, IL 62062-8501
Phone
(618) 391-6405
Fax
(618) 288-4088
NPI assigned
Mar 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036085861 IL Primary

Addresses

Primary practice location

6810 State Route 162
Box 215
Maryville, IL 62062-8501

Mailing address

6810 State Route 162
Box 215
Maryville, IL 62062-8501
Phone (618) 391-6405

Other identifiers 1

IdentifierTypeStateIssuer
336047955OtherCONT SUBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20140806000787 IL Practitioner - Family Practice 9335366905 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036085861ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vohra Wound Physicians of Il, S.C. Family Medicine CurrentSince Oct 16, 2023 Accepting new patients

Locations

3601 SW 160th Ave
Ste 250
Miramar, FL 33027
Phone (305) 866-9951

7370 W Talcott Ave
Chicago, IL 60631
Phone (312) 783-3348

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/2474/brand/3/csg/81/fhir/r4

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": "1143504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1760442198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6810 STATE ROUTE 162",
            "address_2": "BOX 215",
            "city": "MARYVILLE",
            "state": "IL",
            "postal_code": "620628501",
            "telephone_number": "618-391-6405",
            "fax_number": "618-288-4088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6810 STATE ROUTE 162",
            "address_2": "BOX 215",
            "city": "MARYVILLE",
            "state": "IL",
            "postal_code": "620628501",
            "telephone_number": "618-391-6405",
            "fax_number": "618-288-4088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWEARINGEN",
        "first_name": "JEAN",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-28",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036085861",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONT SUBS",
            "identifier": "336047955",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Maryville, IL

Sources for this page

Verify at the official NPI Registry.