Individual provider Active NPI

Allen Gray Swift, MD

  • General Practice Physician
  • Bonifay, FL
National Provider Identifier
1992925937
Registry record updated Jan 29, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
ACN 263 Issued in FL
Practice address
603 Scenic Circle Dr
Bonifay, FL 32425-3060
Phone
(850) 547-8500
Fax
(850) 547-8515
NPI assigned
May 1, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 29, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 14557 PR
General Practice Physician 208D00000X ACN 263 FL Primary

Addresses

Primary practice location

603 Scenic Circle Dr
Bonifay, FL 32425-3060

Mailing address

603 Scenic Circle Dr
Bonifay, FL 32425-3060
Phone (850) 547-8500

Other identifiers 1

IdentifierTypeStateIssuer
000207600MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20080808000389 FL Practitioner - General PracticePractitioner - Family Practice 5496744963 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General PracticeAlso: Family Practice
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Department of HealthGroup PAC ID 3072424282, shared by 68 NPIs, 126 clinicians

Practice addresses (Care Compare)

603 Scenic Circle Dr
Bonifay, FL 32425-3060
Phone 8505478500223

Hospital & facility affiliations

  • Doctors Memorial Hospital Hospital, Bonifay, FL, CCN 101307

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ACN 263FLMDGeneral Practice Physician
14557PRMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Department of Health CurrentSince Apr 15, 2011 Accepting new patients
Florida Department of Health CurrentSince Apr 15, 2011 Accepting new patients
Florida Department of Health CurrentSince May 16, 2014 Accepting new patients
Toa Baja Health Center Past Accepting new patients
Florida Department of Health Past Accepting new patients

Locations

603 Scenic Circle Dr
Bonifay, FL 32425
Phone (850) 547-3691

1338 South Blvd
Chipley, FL 32428
Phone (850) 638-6240

2475 Garrison Ave
Port St Joe, FL 32456
Phone (850) 227-1276

Organizations & group practices 5

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.

Hospital & facility affiliations 1

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": "1177977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359417600000",
    "number": "1992925937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "603 SCENIC CIRCLE DR",
            "city": "BONIFAY",
            "state": "FL",
            "postal_code": "324253060",
            "telephone_number": "850-547-8500",
            "fax_number": "850-547-8515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "603 SCENIC CIRCLE DR",
            "city": "BONIFAY",
            "state": "FL",
            "postal_code": "324253060",
            "telephone_number": "850-547-8500",
            "fax_number": "850-547-8515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWIFT",
        "first_name": "ALLEN",
        "middle_name": "GRAY",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-01",
        "last_updated": "2013-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "14557",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ACN 263",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000207600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bonifay, FL

Sources for this page

Verify at the official NPI Registry.