Individual provider Active NPI

Ian Christopher Quinn, D.O.

  • Sports Medicine (Family Medicine) Physician
  • Braselton, GA
National Provider Identifier
1578098240
Registry record updated Jun 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
License
89636 Issued in GA
Practice address
1270 Friendship Rd.
Braselton, GA 30517-3051
Phone
(678) 207-4050
Fax
(678) 207-4051
NPI assigned
May 1, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2023

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 89636 GA
Family Medicine Physician 207Q00000X 2020-02252 NC
Sports Medicine (Family Medicine) Physician 207QS0010X 2020-02252 NC
Student in an Organized Health Care Education/Training Program 390200000X
Sports Medicine (Family Medicine) Physician 207QS0010X 89636 GA Primary

Addresses

Primary practice location

1270 Friendship Rd.
Braselton, GA 30517-3051

Mailing address

PO Box 658
Gainesville, GA 30503-0658
Phone (770) 718-1122

Other practice location 1

725 Jesse Jewell Pkwy SE
Gainesville, GA 30501-3834
Phone (707) 535-0191

Other practice location 2

725 Jesse Jewell Pkwy SE Ste 270
Gainesville, GA 30501-3846
Phone (770) 718-1122

Other practice location 3

801 Austin Dr
Demorest, GA 30535-4513
Phone (706) 754-8066

Other practice location 4

655 Jesse Jewell Pkwy
Gainesville, GA 30501-3854
Phone (770) 532-7092

Other practice location 5

835 Austin Dr
Demorest, GA 30535-4513
Phone (706) 754-8066

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, GA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20201109001778 NC Practitioner - Family PracticePractitioner - Sports Medicine 1759653132
I20210825000386 GA Practitioner - Family Practice 1759653132 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Edward Via Col of Osteo Medicine-Carolinas Campus, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Longstreet Clinic, PCGroup PAC ID 2668465733, 140 clinicians
Northeast Georgia Community Physicians LLCGroup PAC ID 3274010582, 129 clinicians

Practice addresses (Care Compare)

1270 Friendship Rd
Braselton, GA 30517-5608
Phone (770) 533-6511

725 Jesse Jewell Pkwy SE
Gainesville, GA 30501-3834
Phone (770) 297-5700

Hospital & facility affiliations

  • Northeast Georgia Medical Center, Inc Hospital, Gainesville, GA, CCN 110029
  • Northeast Georgia Medical Center Habersham Hospital, Demorest, GA, CCN 110041

Merit-based Incentive Payment System (MIPS)

Final score
89.1 of 100Reported as group
Quality
87.6
Promoting interoperability
100
Improvement activities
40
Cost
76.07

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
89636GAMDSports Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Longstreet Clinic, PC Family Medicine CurrentSince Aug 4, 2021 Accepting new patients
The Longstreet Clinic PC CurrentSince Aug 4, 2021 Accepting new patients

Locations

1270 Friendship Rd
Braselton, GA 30517
Phone (678) 207-4200

801 Austin Dr
Demorest, GA 30535
Phone (706) 754-8066

835 Austin Dr
Demorest, GA 30535
Phone (706) 754-8518

655 Jesse Jewell Pkwy SE
Gainesville, GA 30501
Phone (770) 535-9391

725 Jesse Jewell Pkwy SE
Gainesville, GA 30501
Phone (770) 297-2200

725 Jesse Jewell Pkwy SE
Ste 270
Gainesville, GA 30501
Phone (770) 718-1122

Organizations & group practices 3

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 2

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": "1493596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685664000000",
    "number": "1578098240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 658",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305030658",
            "telephone_number": "770-718-1122",
            "fax_number": "770-533-4786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1270 FRIENDSHIP RD.",
            "city": "BRASELTON",
            "state": "GA",
            "postal_code": "305173051",
            "telephone_number": "678-207-4050",
            "fax_number": "678-207-4051"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "725 Jesse Jewell Pkwy SE",
            "address_purpose": "LOCATION",
            "city": "Gainesville",
            "state": "GA",
            "postal_code": "305013834",
            "country_code": "US",
            "telephone_number": "707-535-0191",
            "fax_number": "770-535-0916",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "725 Jesse Jewell Pkwy SE Ste 270",
            "address_purpose": "LOCATION",
            "city": "Gainesville",
            "state": "GA",
            "postal_code": "305013846",
            "country_code": "US",
            "telephone_number": "770-718-1122",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "801 Austin Dr",
            "address_purpose": "LOCATION",
            "city": "Demorest",
            "state": "GA",
            "postal_code": "305354513",
            "country_code": "US",
            "telephone_number": "706-754-8066",
            "fax_number": "706-754-8086",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "655 Jesse Jewell Pkwy",
            "address_purpose": "LOCATION",
            "city": "Gainesville",
            "state": "GA",
            "postal_code": "305013854",
            "country_code": "US",
            "telephone_number": "770-532-7092",
            "fax_number": "770-536-0383",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "835 Austin Dr",
            "address_purpose": "LOCATION",
            "city": "Demorest",
            "state": "GA",
            "postal_code": "305354513",
            "country_code": "US",
            "telephone_number": "706-754-8066",
            "fax_number": "706-754-8086",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "QUINN",
        "first_name": "IAN",
        "middle_name": "CHRISTOPHER",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-01",
        "last_updated": "2023-06-02",
        "certification_date": "2023-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "89636",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2020-02252",
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "NC",
            "license": "2020-02252",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "GA",
            "license": "89636",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Braselton, GA

Sources for this page

Verify at the official NPI Registry.