Individual provider Active NPI

Julie Ann Quillin, NP-C

  • Family Nurse Practitioner
  • Ronceverte, WV
National Provider Identifier
1548793623
Registry record updated Oct 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
69950 Issued in WV
Practice address
9016 Seneca TRL S
Ronceverte, WV 24970-8375
Phone
(681) 318-3477
Fax
(681) 318-3479
NPI assigned
Apr 6, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 69950 WV Primary

Addresses

Primary practice location

9016 Seneca TRL S
Ronceverte, WV 24970-8375

Mailing address

499 Meadow LN
Lewisburg, WV 24901-1807
Phone (304) 647-0957

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20190822000956 WV Practitioner - Nurse Practitioner 8527337062 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
United Physicians Care IncGroup PAC ID 6103814017, 119 clinicians

Practice addresses (Care Compare)

9016 Seneca TRL S
Ronceverte, WV 24970-8375
Phone (681) 318-3477

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
69950WVMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
United Physicians Care Inc CurrentSince Oct 25, 2024 Accepting new patients
Rainelle Medical Center Inc CurrentSince Jul 1, 2019 Accepting new patients
Rainelle Medical Center Inc Current Accepting new patients
Rainelle Medical Center, Inc. CurrentSince Jul 1, 2019 Accepting new patients
United Physicians Care Inc CurrentSince Oct 25, 2024 Accepting new patients
Wvva Health Care Alliance, PC Past Accepting new patients

Locations

626 Elk St
Gassaway, WV 26624
Phone (304) 364-2401

390 Industrial Park Rd
Maxwelton, WV 24957
Phone (681) 318-3610

176 Medical Center Dr
Rainelle, WV 25962

205 Medical Center Dr
Rainelle, WV 25962
Phone (304) 438-1922

9016 Seneca Trl S
Ronceverte, WV 24970
Phone (304) 647-4968

2373 W Main St
Ste 102
Salem, WV 26426
Phone (304) 782-2000

Organizations & group practices 6

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1491436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728950400000",
    "number": "1548793623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "499 MEADOW LN",
            "city": "LEWISBURG",
            "state": "WV",
            "postal_code": "249011807",
            "telephone_number": "304-647-0957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9016 SENECA TRL S",
            "city": "RONCEVERTE",
            "state": "WV",
            "postal_code": "249708375",
            "telephone_number": "681-318-3477",
            "fax_number": "681-318-3479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUILLIN",
        "first_name": "JULIE",
        "middle_name": "ANN",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-06",
        "last_updated": "2024-10-15",
        "certification_date": "2024-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WV",
            "license": "69950",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ronceverte, WV

Sources for this page

Verify at the official NPI Registry.