Individual provider Active NPI

Katie Granger Swanton, PA-C

  • Medical Physician Assistant
  • Beaumont, TX
National Provider Identifier
1952568909
Registry record updated Mar 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA03296 Issued in TX
Practice address
205 N 11TH St
Beaumont, TX 77702-2213
Phone
(409) 892-7090
Fax
(409) 892-4324
NPI assigned
May 19, 2008
Last updated
Mar 28, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA03296 TX Primary
Internal Medicine Physician 207R00000X PA03296 TX
Otolaryngology Physician 207Y00000X PA03296 TX

Addresses

Primary practice location

205 N 11TH St
Beaumont, TX 77702-2213

Mailing address

610 Strickland Dr Ste 270
Orange, TX 77630-4788
Phone (409) 883-5600

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20260529001212 TX Practitioner - Physician Assistant 8224508379 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2001
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

205 N 11TH St
Beaumont, TX 77702-2213

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PA03296TXMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Russell Perry, MD, PA CurrentSince Mar 31, 2024 Accepting new patients
Orange Clinical Associates PA Internal Medicine PastSince Jun 28, 1995 Accepting new patients
William a. Fawcett, IV, MD Past Accepting new patients

Locations

205 N 11th St
Beaumont, TX 77702
Phone (409) 892-7090

2965 Harrison Ave
Ste 315
Beaumont, TX 77702
Phone (409) 892-2262

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1211155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711584000000",
    "number": "1952568909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 STRICKLAND DR STE 270",
            "city": "ORANGE",
            "state": "TX",
            "postal_code": "776304788",
            "telephone_number": "409-883-5600",
            "fax_number": "409-883-3570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 N 11TH ST",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777022213",
            "telephone_number": "409-892-7090",
            "fax_number": "409-892-4324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWANTON",
        "first_name": "KATIE",
        "middle_name": "GRANGER",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-19",
        "last_updated": "2024-03-28",
        "certification_date": "2024-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "PA03296",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "PA03296",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "TX",
            "license": "PA03296",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaumont, TX

Sources for this page

Verify at the official NPI Registry.