NPIMap

Individual provider Active NPI

Shawna R Swinigan, PA-C

  • Medical Physician Assistant
  • Collinsville, IL
National Provider Identifier
1932391687
Registry record updated Feb 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
085001301 Issued in IL
Practice address
501 Belt Line Rd
Suite 20-D
Collinsville, IL 62234-4410
Phone
(618) 343-6005
Fax
(618) 343-9114
NPI assigned
Aug 16, 2007
Last updated
Feb 28, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085001301 IL
Medical Physician Assistant 363AM0700X 2009007402 MO
Medical Physician Assistant 363AM0700X 085001301 IL Primary

Addresses

Primary practice location

501 Belt Line Rd
Suite 20-D
Collinsville, IL 62234-4410

Mailing address

4500 Memorial Drive
Memorial Hospital Medical Affairs
Belleville, IL 62226
Phone (618) 257-4644

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130627000666 IL Practitioner - Physician Assistant 9032396023 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Fairview Heights Medical Group SCGroup PAC ID 6800784083, 448 clinicians

Practice addresses (Care Compare)

1 Memorial Dr
Alton, IL 62002-6722
Phone (618) 463-7240

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
2009007402MOMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Heights Medical Group SC CurrentSince Dec 24, 2017 Accepting new patients
Granite City Clinic Corp Past Accepting new patients
Granite City Clinic Corp Past Accepting new patients
PC Associates, LLC Past Accepting new patients
Granite City Physicians Corp Past Accepting new patients

Locations

1 Memorial Dr
Alton, IL 62002
Phone (618) 463-7240

4500 Memorial Dr
Belleville, IL 62226
Phone (618) 233-7750

1095 Belt Line Rd
Ste 500
Collinsville, IL 62234
Phone (618) 343-6005

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1187222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614470400000",
    "number": "1932391687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4500 MEMORIAL DRIVE",
            "address_2": "MEMORIAL HOSPITAL MEDICAL AFFAIRS",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "62226",
            "telephone_number": "618-257-4644",
            "fax_number": "618-257-6946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 BELT LINE RD",
            "address_2": "SUITE 20-D",
            "city": "COLLINSVILLE",
            "state": "IL",
            "postal_code": "622344410",
            "telephone_number": "618-343-6005",
            "fax_number": "618-343-9114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWINIGAN",
        "first_name": "SHAWNA",
        "middle_name": "R",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-16",
        "last_updated": "2021-02-28",
        "certification_date": "2021-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085001301",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MO",
            "license": "2009007402",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IL",
            "license": "085001301",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "BJC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "501 Belt Line Rd",
            "address_2": "Suite 20-D",
            "city": "Collinsville",
            "state": "IL",
            "country_code": "US",
            "postal_code": "622344410",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Collinsville, IL

Sources for this page

Verify at the official NPI Registry.