Individual provider Active NPI

Hailey Beth Quick, RN

  • Occupational Therapist
  • Logan, WV
National Provider Identifier
1457511933
Registry record updated Jan 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
1556 Issued in WV
Practice address
506 Holly Ave
Logan, WV 25601-3306
Phone
(304) 752-1550
NPI assigned
Jun 10, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 5, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 1556 WV Primary

Addresses

Primary practice location

506 Holly Ave
Logan, WV 25601-3306

Mailing address

128 Sayer Cir
Logan, WV 25601-3054
Phone (304) 752-1037

Other identifiers 1

IdentifierTypeStateIssuer
0060164000MedicaidWV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2011
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1212 Van Voorhis Rd
Suite C
Morgantown, WV 26505-0286

125 C Main St
Man, WV 25635-1239

125 Main St
Suite C
Man, WV 25635-1239

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1556WVMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1213056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325721600000",
    "number": "1457511933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "128 SAYER CIR",
            "city": "LOGAN",
            "state": "WV",
            "postal_code": "256013054",
            "telephone_number": "304-752-1037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "506 HOLLY AVE",
            "city": "LOGAN",
            "state": "WV",
            "postal_code": "256013306",
            "telephone_number": "304-752-1550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUICK",
        "first_name": "HAILEY",
        "middle_name": "BETH",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-10",
        "last_updated": "2012-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WV",
            "license": "1556",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0060164000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Logan, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.