Kelly Swofford, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP136080 Issued in TX

Practice address

2451 S FM 51 Ste 200
Decatur, TX 76234-3860

Phone

(940) 627-2409

NPI assigned

Dec 20, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TX

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Wise Clinical Care Associates

  • Family Medicine Physician
  • Bridgeport, TX
  • NPI 1679719801
  Medicare reassignment NPD
• Wise Clinical Care Associates

  • Urgent Care Clinic/Center
  • Haslet, TX
  • NPI 1386112506
  NPD (past)

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

{
    "created_epoch": "1513728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556582400000",
    "number": "1770099194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2078",
            "city": "DECATUR",
            "state": "TX",
            "postal_code": "762346156",
            "telephone_number": "940-627-2409",
            "fax_number": "940-627-4709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2451 S FM 51 STE 200",
            "city": "DECATUR",
            "state": "TX",
            "postal_code": "762343860",
            "telephone_number": "940-627-2409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWOFFORD",
        "first_name": "KELLY",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-12-20",
        "last_updated": "2019-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP136080",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "379873801",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSTX",
            "identifier": "8HW711",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sunny Hills Inc
• Surgical Iom, LLC
• Harpreet Singh Suri, MD
• Sven Hoge, DMD, PLLC (Decatur Dental)
• Johnathan Joel Swofford, FNP-C
• Amy Swoyer, M.S. CCC-SLP
• Jessica L Szatko, APRN
• Marilyn Tabanian, RN
• Tad Montgomery, Inc.
• Laura Tanner, LCSW

• Family Nurse Practitioner in Decatur, TX
• Providers in Decatur, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.