Kent S Quinn, MD

Primary specialty

Body Imaging PhysicianTaxonomy code 2085B0100X

License

21181 Issued in IA

Practice address

1 Good Samaritan Way
Attn Radiology Dept
Mount Vernon, IL 62864-2402

Phone

(618) 242-4600

Fax

(618) 242-4600

NPI assigned

Sep 14, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Central Iowa Hospital Corporation

  • Pharmacy
  • Des Moines, IA
  • NPI 1003352949
  NPD (past)

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

{
    "created_epoch": "1126656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467676800000",
    "number": "1083609184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 66971",
            "address_2": "DEPT MR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631666971",
            "telephone_number": "303-465-0401",
            "fax_number": "303-438-1351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 GOOD SAMARITAN WAY",
            "address_2": "ATTN RADIOLOGY DEPT",
            "city": "MOUNT VERNON",
            "state": "IL",
            "postal_code": "628642402",
            "telephone_number": "618-242-4600",
            "fax_number": "618-242-4600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUINN",
        "first_name": "KENT",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-14",
        "last_updated": "2016-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085B0100X",
            "taxonomy_group": "",
            "desc": "Radiology, Body Imaging",
            "state": "IA",
            "license": "21181",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7191098*",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Progressive Housing, Inc.
• Prompt Care
• Melissa Pryer, RD
• Raquel Pulliam
• Osman Javed Qaiyum, M.D.
• Glenda Ann Raby, MS., CCC-SLP
• David Peter Rakey, CRNA
• Bryon Theron Ramos, ATC, CSCS
• Ronald Edward Rankin, DMD
• Tara Denise Rapp

• Body Imaging Physician in Mount Vernon, IL
• Providers in Mount Vernon, IL by specialty
• Body Imaging Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.