Individual provider Active NPI

Quinta Nfor, AGNP-DNP

  • Nurse Practitioner
  • New Berlin, WI
National Provider Identifier
1164808317
Registry record updated Feb 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
6418-33 Issued in WI
Practice address
12555 W National Ave Ste 200
New Berlin, WI 53151-4061
Phone
(262) 754-2555
Fax
(262) 754-2552
NPI assigned
Aug 10, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 6418-33 WI Primary

Addresses

Primary practice location

12555 W National Ave Ste 200
New Berlin, WI 53151-4061

Mailing address

12555 W National Ave Ste 200
New Berlin, WI 53151-4061
Phone (262) 754-2555

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20151118001175 WI Order and Referring Only - Nurse Practitioner 9436459757

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Anastasia Care Home LLC Current Accepting new patients
Inpatient Consultants of Illinois, P.C. Nurse Practitioner Past Accepting new patients
Internists LTD PastSince Feb 25, 2024 Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/2226/brand/1/csg/1/fhir/r4

Organizations & group practices 3

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": "1439164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708300800000",
    "number": "1164808317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12555 W NATIONAL AVE STE 200",
            "city": "NEW BERLIN",
            "state": "WI",
            "postal_code": "531514061",
            "telephone_number": "262-754-2555",
            "fax_number": "262-754-2552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12555 W NATIONAL AVE STE 200",
            "city": "NEW BERLIN",
            "state": "WI",
            "postal_code": "531514061",
            "telephone_number": "262-754-2555",
            "fax_number": "262-754-2552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NFOR",
        "first_name": "QUINTA",
        "credential": "AGNP-DNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-08-10",
        "last_updated": "2024-02-19",
        "certification_date": "2024-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "6418-33",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Berlin, WI

Sources for this page

Verify at the official NPI Registry.