NPIMap

Individual provider Active NPI

Christopher J Quinn, MD

  • Family Medicine Physician
  • Granger, IN
National Provider Identifier
1073503512
Registry record updated Aug 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
01038532A Issued in IN
Practice address
52500 Fir Rd
Granger, IN 46530-8579
Phone
(574) 271-0700
Fax
(574) 273-5648
NPI assigned
Oct 26, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 01038532A IN Primary

Addresses

Primary practice location

52500 Fir Rd
Granger, IN 46530-8579

Mailing address

52500 Fir Rd
Granger, IN 46530-8579
Phone (574) 271-0700

Other identifiers 1

IdentifierTypeStateIssuer
100092290MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091211000362 IN Practitioner - Family Practice 6507953452 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Indiana University School of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The South Bend Clinic LLCGroup PAC ID 3779577937, 171 clinicians

Practice addresses (Care Compare)

211 N Eddy St
South Bend, IN 46617-2808
Phone (574) 234-8161

52500 Fir Rd
Granger, IN 46530-8579
Phone (574) 271-0700

Hospital & facility affiliations

  • Saint Joseph Vna Home Care Home health agency, South Bend, IN, CCN 157005
  • Concept Therapy Home Health, LLC Home health agency, South Bend, IN, CCN 157734
  • Aunova Home Care LLC Home health agency, Granger, IN, CCN 157683
  • Caring Cove Hospice LLC Hospice, Mishawaka, IN, CCN 151641
  • Paradigm Health Hospice, Indianapolis, IN, CCN 151611
  • Community Hospital of Bremen Inc Hospital, Bremen, IN, CCN 151300
  • Memorial Hospital of South Bend Hospital, South Bend, IN, CCN 150058
  • Saint Joseph Regional Medical Center Hospital, Mishawaka, IN, CCN 150012
  • Healthwin Health & Rehabilitation Nursing home, South Bend, IN, CCN 155153

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The South Bend Clinic, LLC CurrentSince Aug 26, 1993 Accepting new patients
The South Bend Clinic LLC CurrentSince Nov 1, 2009 Accepting new patients

Locations

52500 Fir Rd
Granger, IN 46530
Phone (574) 204-7050

211 N Eddy St
South Bend, IN 46617
Phone (574) 237-9331

Interoperability endpoints

  • Direct secure messaging: cquinn254823@dulyhealthandcare.direct-ci.com
  • Direct secure messaging: cquinn1158765@direct.trinity-health.org
  • FHIR API: https://epicproxy.et1296.epichosted.com/APIProxyPRD/api/FHIR/R4/

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Healthwin Health & RehabilitationSouth Bend, IN, CCN 155153 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jan 8, 2025
Apr 17, 2025

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 2

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 12

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": "1130284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470096000000",
    "number": "1073503512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "52500 FIR RD",
            "city": "GRANGER",
            "state": "IN",
            "postal_code": "465308579",
            "telephone_number": "574-271-0700",
            "fax_number": "574-273-5648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "52500 FIR RD",
            "city": "GRANGER",
            "state": "IN",
            "postal_code": "465308579",
            "telephone_number": "574-271-0700",
            "fax_number": "574-273-5648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUINN",
        "first_name": "CHRISTOPHER",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-26",
        "last_updated": "2016-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01038532A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100092290",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Granger, IN

Sources for this page

Verify at the official NPI Registry.