Individual provider Active NPI

Lynn D. Quillan, N.P.

  • Women's Health Nurse Practitioner
  • Greenville, SC
National Provider Identifier
1417905340
Registry record updated May 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
2392 Issued in SC
Practice address
1120 Grove Rd
Suite B
Greenville, SC 29605-4656
Phone
(864) 455-6444
Fax
(864) 455-6598
NPI assigned
May 4, 2006
Last updated
May 13, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 2392 SC Primary

Addresses

Primary practice location

1120 Grove Rd
Suite B
Greenville, SC 29605-4656

Mailing address

300 E McBee Ave FL 4
Greenville, SC 29601-2842
Phone (864) 522-8614

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lquillan5055@direct.ghs.myhfn.org

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)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
2392SCMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Greenville Proaxis Therapy, LLC Past Accepting new patients
Greenville Health System Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: lquillan5055@direct.ghs.myhfn.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620864000000",
    "number": "1417905340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E MCBEE AVE FL 4",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296012842",
            "telephone_number": "864-522-8614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 GROVE RD",
            "address_2": "SUITE B",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296054656",
            "telephone_number": "864-455-6444",
            "fax_number": "864-455-6598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUILLAN",
        "first_name": "LYNN",
        "middle_name": "D.",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-04",
        "last_updated": "2021-05-13",
        "certification_date": "2021-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "SC",
            "license": "2392",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lquillan5055@direct.ghs.myhfn.org",
            "affiliation": "N",
            "address_1": "1120 Grove Rd",
            "address_2": "Suite B",
            "city": "Greenville",
            "state": "SC",
            "country_code": "US",
            "postal_code": "296054656",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 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.