Individual provider Active NPI

Carolyn Quan, MD

  • Hospitalist Physician
  • Dallas, TX
National Provider Identifier
1154351427
Registry record updated Oct 16, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
J6674 Issued in TX
Practice address
3600 Gaston Ave
#550
Dallas, TX 75246-1904
Phone
(214) 821-1177
Fax
(214) 821-1193
NPI assigned
Jul 3, 2006
Last updated
Oct 16, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X J6674 TX Primary

Addresses

Primary practice location

3600 Gaston Ave
#550
Dallas, TX 75246-1904

Mailing address

3600 Gaston Ave
#550
Dallas, TX 75246-1904
Phone (214) 821-1177

Other identifiers 1

IdentifierTypeStateIssuer
84238SOtherTXBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
National Primary Care Network, PA Hospitalist Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192492800000",
    "number": "1154351427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 GASTON AVE",
            "address_2": "#550",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752461904",
            "telephone_number": "214-821-1177",
            "fax_number": "214-821-1193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 GASTON AVE",
            "address_2": "#550",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752461904",
            "telephone_number": "214-821-1177",
            "fax_number": "214-821-1193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUAN",
        "first_name": "CAROLYN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-03",
        "last_updated": "2007-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "TX",
            "license": "J6674",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "84238S",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2007; 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.