Active NPI
Kevin L Quinn, MD
- Diagnostic Radiology Physician
- Charleston, SC
National Provider Identifier
1417912973
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 11458
- Practice address
- 109 Bee St
Charleston, SC 29401-5703 - Phone
- (843) 577-5011
- NPI assigned
- Apr 19, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Body Imaging Physician | 2085B0100X | 11458 | NH | |
| Diagnostic Radiology Physician | 2085R0202X | 11458 | NH | Primary |
Addresses
Primary practice location
109 Bee St
Charleston, SC 29401-5703
Mailing address
109 Bee St
Charleston, SC 29401-5703
Phone (843) 577-5011
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 30201769 | Medicaid | NH | |
| 01Y003557NH02 | Other | NH | BLUE CROSS |
| 01Y003557 NH05 | Other | NH | ANTHEM MCH TAX ID |
| 300123698 | Other | NH | RAILROAD MEDICARE |
| 011458 | Other | NH | TUFTS |
| 2675858 | Other | NH | AETNA |
| 294668 | Other | NH | CIGNA |
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
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11458 | NH | MD | Body Imaging Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southern New Hampshire Radiology Consultants PC | Diagnostic Radiology | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Diagnostic Radiology Physician
- Bedford, NH
- NPI 1780648915
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1145404800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1518480000000",
"number": "1417912973",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "109 BEE ST",
"city": "CHARLESTON",
"state": "SC",
"postal_code": "294015703",
"telephone_number": "843-577-5011"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "109 BEE ST",
"city": "CHARLESTON",
"state": "SC",
"postal_code": "294015703",
"telephone_number": "843-577-5011"
}
],
"practiceLocations": [],
"basic": {
"last_name": "QUINN",
"first_name": "KEVIN",
"middle_name": "L",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-19",
"last_updated": "2018-02-13",
"status": "A"
},
"taxonomies": [
{
"code": "2085B0100X",
"taxonomy_group": "",
"desc": "Radiology, Body Imaging",
"state": "NH",
"license": "11458",
"primary": false
},
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "NH",
"license": "11458",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "30201769",
"state": "NH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "01Y003557NH02",
"state": "NH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM MCH TAX ID",
"identifier": "01Y003557 NH05",
"state": "NH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "300123698",
"state": "NH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TUFTS",
"identifier": "011458",
"state": "NH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "2675858",
"state": "NH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "294668",
"state": "NH"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Charleston, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.