Individual provider Active NPI

Marshall K Quinn, M.D.

  • Family Medicine Physician
  • Beulaville, NC
National Provider Identifier
1154404176
Registry record updated Mar 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
28558 Issued in NC
Practice address
119 Crossover Rd
Beulaville, NC 28518-8801
Phone
(910) 298-3125
Fax
(910) 298-8101
NPI assigned
Oct 23, 2006
Last updated
Mar 7, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2014

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 28558 NC Primary

Addresses

Primary practice location

119 Crossover Rd
Beulaville, NC 28518-8801

Mailing address

119 Crossover Rd
Beulaville, NC 28518-8801
Phone (910) 298-3125

Other identifiers 1

IdentifierTypeStateIssuer
8969742MedicaidNC

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040312000851 NC Practitioner - Family Practice 7719876234 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Goshen Medical Center Incorporated CurrentSince Sep 26, 2003 Accepting new patients
Goshen Medical Center Incorporated CurrentSince Sep 26, 2003 Accepting new patients
Goshen Medical Center, Incorporated Current Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

119 Crossover Rd
Beulaville, NC 28518
Phone (910) 298-3125

444 SW Center St
Faison, NC 28341
Phone (910) 267-0421

Interoperability endpoints

  • Direct secure messaging: bquinn@goshenmedical.cloudcraftdirect.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, 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": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394150400000",
    "number": "1154404176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 CROSSOVER RD",
            "city": "BEULAVILLE",
            "state": "NC",
            "postal_code": "285188801",
            "telephone_number": "910-298-3125",
            "fax_number": "910-298-8101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 CROSSOVER RD",
            "city": "BEULAVILLE",
            "state": "NC",
            "postal_code": "285188801",
            "telephone_number": "910-298-3125",
            "fax_number": "910-298-8101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUINN",
        "first_name": "MARSHALL",
        "middle_name": "K",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-23",
        "last_updated": "2014-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "28558",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8969742",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beulaville, NC

Sources for this page

Verify at the official NPI Registry.