NPIMap

Organization Active NPI

QC Family Practice

  • Primary Care Clinic/Center
  • Johnson City, TN
National Provider Identifier
1215469358
Registry record updated Mar 29, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
14954 Issued in TN
Legal business name
QC FAMILY PRACTICE
Practice address
508 Princeton Rd
Suite 104
Johnson City, TN 37601-2060
Phone
(423) 384-0614
NPI assigned
Mar 29, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2017

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

Authorized official

Name
Quinton W Carroll, APRNNPI 1619187283
Title
Owner
Phone
(423) 384-0614

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X 14954 TN Primary

Addresses

Primary practice location

508 Princeton Rd
Suite 104
Johnson City, TN 37601-2060

Mailing address

508 Princeton Rd
Suite 104
Johnson City, TN 37601-2060
Phone (423) 384-0614

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1490745600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1490745600000",
    "number": "1215469358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "508 PRINCETON RD",
            "address_2": "SUITE 104",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376012060",
            "telephone_number": "423-384-0614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "508 PRINCETON RD",
            "address_2": "SUITE 104",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376012060",
            "telephone_number": "423-384-0614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QC FAMILY PRACTICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-29",
        "last_updated": "2017-03-29",
        "status": "A",
        "authorized_official_last_name": "CARROLL",
        "authorized_official_first_name": "QUINTON",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "423-384-0614",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "TN",
            "license": "14954",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2017; 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.