Individual provider Active NPI

Grace Elizabeth Quinney, PHYSICIAN ASSISTANT

  • Pediatrics Physician
  • Charlotte, NC
National Provider Identifier
1073336285
Registry record updated Nov 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
0010-14839 Issued in NC
Practice address
1001 Blythe Blvd
Charlotte, NC 28203-5866
Phone
(704) 381-8840
NPI assigned
Nov 5, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 0010-14839 NC Primary

Addresses

Primary practice location

1001 Blythe Blvd
Charlotte, NC 28203-5866

Mailing address

128 Bowden LN
Gastonia, NC 28056-9670

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20250224001914 NC Practitioner - Physician Assistant 1759801525 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinas Medical Center CurrentSince Jan 6, 2025 Accepting new patients
Carolinas Medical Center CurrentSince Jan 6, 2025 Accepting new patients
Carolinas Medical Center Pediatrics Past Accepting new patients

Locations

1001 Blythe Blvd
Ste 200
Charlotte, NC 28203
Phone (704) 373-0544

1000 Blythe Blvd
Charlotte, NC 28203
Phone (704) 351-3791

Interoperability endpoints

  • Direct secure messaging: gkiser1229045@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1730764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730764800000",
    "number": "1073336285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "128 BOWDEN LN",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280569670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 BLYTHE BLVD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282035866",
            "telephone_number": "704-381-8840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUINNEY",
        "first_name": "GRACE",
        "middle_name": "ELIZABETH",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-05",
        "last_updated": "2024-11-05",
        "certification_date": "2024-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "0010-14839",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.