Individual provider Active NPI

Kimberly Sue Quinn, APRN

  • Family Nurse Practitioner
  • Dedham, MA
National Provider Identifier
1336499532
Registry record updated Aug 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN2281552 Issued in MA
Practice address
947 Providence Hwy
Dedham, MA 02026
Phone
(866) 389-2727
NPI assigned
Sep 14, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN2281552 MA Primary

Addresses

Primary practice location

947 Providence Hwy
Dedham, MA 02026

Mailing address

947 Providence Hwy
Dedham, MA 02026-6838
Phone (866) 389-2727

Other practice location 1

978 Boylston Street
MinuteClinic - Newton
Newton, MA 02464
Phone (866) 389-2727

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20121128000753 MA Practitioner - Nurse Practitioner 5698927531 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
First Psychiatric Planners, IncGroup PAC ID 3476653387, 11 clinicians

Practice addresses (Care Compare)

300 S St
Chestnut Hill, MA 02467-3658
Phone (617) 469-0300

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN2281552MAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
First Psychiatric Planners, Inc CurrentSince Dec 1, 2014 Accepting new patients
Square Medical Group LLC CurrentSince Oct 1, 2018 Accepting new patients

Locations

300 South St
Chestnut Hill, MA 02467
Phone (617) 469-0300

884 Washington St
Fl 1
Weymouth, MA 02189
Phone (781) 812-1643

884 Washington St
Fl 2
Weymouth, MA 02189
Phone (617) 447-2146

Organizations & group practices 2

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": "1347580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533168000000",
    "number": "1336499532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "947 PROVIDENCE HWY",
            "city": "DEDHAM",
            "state": "MA",
            "postal_code": "020266838",
            "telephone_number": "866-389-2727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "947 PROVIDENCE HWY",
            "city": "DEDHAM",
            "state": "MA",
            "postal_code": "02026",
            "telephone_number": "866-389-2727"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "978 Boylston Street",
            "address_2": "MinuteClinic - Newton",
            "address_purpose": "LOCATION",
            "city": "Newton",
            "state": "MA",
            "postal_code": "02464",
            "country_code": "US",
            "telephone_number": "866-389-2727",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "QUINN",
        "first_name": "KIMBERLY",
        "middle_name": "SUE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-14",
        "last_updated": "2018-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "RN2281552",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dedham, MA

Sources for this page

Verify at the official NPI Registry.