Individual provider Active NPI

Gary F. Swann, D.O.

  • Obstetrics & Gynecology Physician
  • Maumee, OH
National Provider Identifier
1861485054
Registry record updated Apr 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
34004478 Issued in OH
Practice address
959 Illinois Ave
Suite E
Maumee, OH 43537-1743
Phone
(419) 893-5588
Fax
(419) 893-6800
NPI assigned
Aug 24, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 34004478 OH Primary

Addresses

Primary practice location

959 Illinois Ave
Suite E
Maumee, OH 43537-1743

Mailing address

959 Illinois Ave
Suite E
Maumee, OH 43537-1743
Phone (419) 893-5588

Other identifiers 2

IdentifierTypeStateIssuer
0731917MedicaidOH
113083633MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20050512000007 OH Practitioner - Obstetrics/Gynecology 9739129487 Practice locations: Maumee, OH

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34004478OHMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lima Memorial Joint Operating Company Past Accepting new patients

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": "1124841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524096000000",
    "number": "1861485054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "959 ILLINOIS AVE",
            "address_2": "SUITE E",
            "city": "MAUMEE",
            "state": "OH",
            "postal_code": "435371743",
            "telephone_number": "419-893-5588",
            "fax_number": "419-893-6800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "959 ILLINOIS AVE",
            "address_2": "SUITE E",
            "city": "MAUMEE",
            "state": "OH",
            "postal_code": "435371743",
            "telephone_number": "419-893-5588",
            "fax_number": "419-893-6800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWANN",
        "first_name": "GARY",
        "middle_name": "F.",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-24",
        "last_updated": "2018-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "OH",
            "license": "34004478",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0731917",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "113083633",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Maumee, OH

Sources for this page

Verify at the official NPI Registry.