Jose Quezada

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

RN292069 Issued in GA

Practice address

1325 Satellite Blvd NW Ste 400
Suwanee, GA 30024-5299

Phone

(263) 678-2633

NPI assigned

Feb 29, 2024

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Mr. Jose D Quezada Professional name

Medicare fee-for-service enrollment

Enrolled in GA

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jose.quezada.2@25899.direct.athenahealth.com

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.

• Psychiatric Professionals of Georgia, LLC

  • Psychiatry Physician
  • Suwanee, GA
  • NPI 1396277968
  Medicare reassignment NPD
• Geode Health Iop LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Suwanee, GA
  • NPI 1609766427
  NPD

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

{
    "created_epoch": "1709164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716336000000",
    "number": "1487411195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1325 SATELLITE BLVD NW STE 400",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300245299",
            "telephone_number": "263-678-2633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 SATELLITE BLVD NW STE 400",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300245299",
            "telephone_number": "263-678-2633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUEZADA",
        "first_name": "JOSE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-02-29",
        "last_updated": "2024-05-22",
        "certification_date": "2024-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "GA",
            "license": "RN292069",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "GA",
            "license": "RN292069",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOSE",
            "last_name": "QUEZADA",
            "middle_name": "D",
            "prefix": "MR.",
            "credential": "RN",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Quality Chronic Care Management LLC
• Benjamin Kwabena Quarshie, M.D
• Stacey M Quinn, ATC
• Abdol Reza Rahbar, D.D.S.
• Sophie Rahman, RBT
• Dimple Raina, M.D.
• Bryan Rainbolt, PA

• Psychiatric/Mental Health Nurse Practitioner in Suwanee, GA
• Providers in Suwanee, GA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.