Jennifer Marie Quinn, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA06712 Issued in TX

Practice address

2485 E Southlake Blvd Ste 200
Southlake, TX 76092-6687

Phone

(817) 303-6647

Fax

(817) 303-6651

NPI assigned

Apr 20, 2010

Last updated

Jun 25, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Jennifer Marie Felan Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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  NPD (past)
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• Grace Elizabeth Brown, MD PA

  • Specialist
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  • NPI 1922448489
  NPD (past)
• PDP of Texas, PLLC

  dba Advanced Dermasurgery Associates

  • Dermatology Physician
  • Dallas, TX
  • NPI 1629025739
  NPD (past)

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

{
    "created_epoch": "1271721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624579200000",
    "number": "1366768079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1115 W RANDOL MILL RD STE 200",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760122577",
            "telephone_number": "817-303-6647",
            "fax_number": "817-303-6651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2485 E SOUTHLAKE BLVD STE 200",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760926687",
            "telephone_number": "817-303-6647",
            "fax_number": "817-303-6651"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1115 W Randol Mill Rd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Arlington",
            "state": "TX",
            "postal_code": "760122577",
            "country_code": "US",
            "telephone_number": "817-303-6647",
            "fax_number": "817-303-6651",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "QUINN",
        "first_name": "JENNIFER",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-20",
        "last_updated": "2021-06-25",
        "certification_date": "2021-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA06712",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "FELAN",
            "middle_name": "MARIE",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Padmaja Puppala, MD
• Jordyn Leigh Purdy, BSW
• Neha Asif Qattan, MS, LMFT
• Syed MM Quadri, MD
• Questcare Matrix PLLC
• Mary Quinn
• Erick Quintero
• Jawad Ahmad Qureshi, MD
• Elli Raab, RBT
• Radiant Family Dental PLLC

• Physician Assistant in Southlake, TX
• Providers in Southlake, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2021; 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.