Dauphin Island Medical LLC

Organization Active NPI Primary Care Nurse Practitioner · Dauphin Island, AL

NPI 1306602065 · NPPES record last updated Feb 21, 2024

Key facts

NPI: 1306602065
Entity type: Organization (NPI type 2)
Primary specialty: Primary Care Nurse Practitioner 363LP2300X
Legal business name: DAUPHIN ISLAND MEDICAL LLC
Practice address: 1008 Alabama Ave
Dauphin Island, AL 36528-4340
Phone: (251) 313-2115
Fax: (251) 313-2102
NPI assigned: Feb 21, 2024
Organization subpart: No

Authorized official

Name: Ms. Tessie Lee O'Quinn, CRNP NPI 1235542713
Title: Owner/Provider
Phone: (843) 425-4818

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

Practitioners 1

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

Tessie O'Quinn, FNP-BC; AGACNP-C Family Nurse Practitioner · Mobile, AL · NPI 1235542713

Medicare reassignment NPD Authorized official AL

Medicare participation

Medicare fee-for-service enrollment: Enrolled in AL

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
O20250306003318	AL	Part B Supplier - Clinic/Group Practice	3072034008	Receives reassigned benefits from 1 practitioner Practice locations: Dauphin Island, AL

National Provider Directory

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Primary Care Nurse Practitioner Group: 193400000X SINGLE SPECIALTY GROUP	363LP2300X			Yes

Addresses

Primary practice location

1008 Alabama Ave
Dauphin Island, AL 36528-4340

Mailing address

1005 Monberaut PL
Dauphin Island, AL 36528-4301
Phone (843) 425-4818

Other providers in Dauphin Island, AL

All providers in Dauphin Island, AL · Primary Care Nurse Practitioner in Alabama

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 21, 2024. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.