Organization Active NPI

Dr. Quinn Ear, Nose & Throat, PC

  • Medical Specialty Clinic/Center
  • Concord, NC
National Provider Identifier
1518136415
Registry record updated Feb 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
License
30709 Issued in NC
Legal business name
DR. QUINN EAR, NOSE & THROAT, PC
Practice address
25 Lake Concord Rd NE
Concord, NC 28025-3015
Phone
(704) 782-6673
NPI assigned
Feb 25, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2008

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

Authorized official

Name
Dr. Robert Patel Quinn, M.D.NPI 1538279120
Title
President
Phone
(704) 782-6673

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X 30709 NC Primary

Addresses

Primary practice location

25 Lake Concord Rd NE
Concord, NC 28025-3015

Mailing address

25 Lake Concord Rd NE
Concord, NC 28025-3015
Phone (704) 782-6673

Other identifiers 1

IdentifierTypeStateIssuer
8969744MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130809000691 NC Part B Supplier - Clinic/Group Practice 9133361702 Receives reassigned benefits from 1 practitioner
Practice locations: Concord, NC; Salisbury, NC

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
34D2015425Dr Quinn Ear Nose and Throat25 Lake Concord Road, Concord, NC 28025Certificate of waiverOct 26, 2026

National Provider Directory

National Provider Directory

Locations

25 Lake Concord Rd NE
Concord, NC 28025
Phone (704) 782-6673

1933 Jake Alexander Blvd W
Ste 101
Salisbury, NC 28147
Phone (704) 637-3778

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1203897600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203897600000",
    "number": "1518136415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 LAKE CONCORD RD NE",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280253015",
            "telephone_number": "704-782-6673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 LAKE CONCORD RD NE",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280253015",
            "telephone_number": "704-782-6673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. QUINN EAR, NOSE & THROAT, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-25",
        "last_updated": "2008-02-25",
        "status": "A",
        "authorized_official_last_name": "QUINN",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "PATEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "704-782-6673",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "NC",
            "license": "30709",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8969744",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.