Mary Young Swanson, F.N.P.

Individual provider Active NPI Family Nurse Practitioner · Pearland, TX

NPI 1962404491 · NPPES record last updated Jan 19, 2011

Key facts

NPI
1962404491
Entity type
Individual (NPI type 1)
Primary specialty
Family Nurse Practitioner 363LF0000X
License
688209 (TX)
Practice address
3223 Broadway St
Pearland, TX 77581-4501
Phone
(281) 485-9034
Fax
(281) 485-9807
NPI assigned
Aug 15, 2005
Sex
Female
Sole proprietor
No

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.

Medicare Care Compare profile

Specialty
Nurse Practitioner
Education
Other, 2005
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

801 N Stilson Rd
Suite 100
Boise, ID 83703-5142

Medicare participation

Medicare fee-for-service enrollment
Enrolled in ID
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20230105000187 ID Practitioner - Nurse Practitioner 6507890332 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mmmedical Group LLC. Current
since Jan 1, 2023
Accepting new patients

Locations

801 N Stilson Rd
Ste 100
Boise, ID 83703
Phone (208) 332-4540

9858 W State St
Star, ID 83669
Phone (208) 286-9471

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/20796/brand/1/csg/1/fhir/r4
  • Direct secure messaging: mary.swanson@93374147657732.direct.elationemr.com

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 688209 TX Yes

Addresses

Primary practice location

3223 Broadway St
Pearland, TX 77581-4501

Mailing address

3223 Broadway St
Pearland, TX 77581-4501
Phone (281) 485-9034

Other providers in Pearland, TX

All providers in Pearland, TX · Family Nurse Practitioner in Texas

Sources for this page

Verify at the official NPI Registry.