Individual provider Active NPI

Joyce Machin Quintavalle, CRNP-P

  • Pediatric Nurse Practitioner
  • Baltimore, MD
National Provider Identifier
1285717371
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
RO41468 Issued in MD
Practice address
501 Stemmers Run Rd
Baltimore, MD 21221-3333
Phone
(410) 574-4397
Fax
(410) 574-4397
NPI assigned
Oct 23, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X RO41468 MD Primary

Addresses

Primary practice location

501 Stemmers Run Rd
Baltimore, MD 21221-3333

Mailing address

17326 Bushland Rd
Parkton, MD 21120-9476
Phone (410) 343-1503

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
RO41468MDMDPediatric Nurse Practitioner

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": "1183852800000",
    "number": "1285717371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17326 BUSHLAND RD",
            "city": "PARKTON",
            "state": "MD",
            "postal_code": "211209476",
            "telephone_number": "410-343-1503",
            "fax_number": "410-343-1562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 STEMMERS RUN RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212213333",
            "telephone_number": "410-574-4397",
            "fax_number": "410-574-4397"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUINTAVALLE",
        "first_name": "JOYCE",
        "middle_name": "MACHIN",
        "name_prefix": "Mrs.",
        "credential": "CRNP-P",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MD",
            "license": "RO41468",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.