Healthcare Provider Details

I. General information

NPI: 1992384820
Provider Name (Legal Business Name): JESSICA SWAVELY DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JESSICA SWAVELY DO

II. Dates (important events)

Enumeration Date: 04/07/2021
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1725 NEW HANOVER MEDICAL PARK DR
WILMINGTON NC
28403-5345
US

IV. Provider business mailing address

1216 ABBY DR
GREENVILLE NC
27834-8867
US

V. Phone/Fax

Practice location:
  • Phone: 910-662-9300
  • Fax:
Mailing address:
  • Phone: 571-276-6232
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number2024-00300
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code2083B0002X
TaxonomyObesity Medicine (Preventive Medicine) Physician
License Number89995472
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: