Individual provider Active NPI

Quin E Chadwick, ARNP

  • Family Nurse Practitioner
  • Panama City, FL
National Provider Identifier
1629072293
Registry record updated Feb 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024174353 Issued in VA
Practice address
1008 Jenks Ave
Panama City, FL 32401-2437
Phone
(850) 215-3000
Fax
(850) 215-3000
NPI assigned
Jun 10, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN2911562 FL
Family Nurse Practitioner 363LF0000X 0024174353 VA Primary

Addresses

Primary practice location

1008 Jenks Ave
Panama City, FL 32401-2437

Mailing address

1008 Jenks Ave
Panama City, FL 32401-2437
Phone (850) 215-3000

Other practice location 1

200 E 5th St
Chase City, VA 23924
Phone (434) 372-0900

Other identifiers 1

IdentifierTypeStateIssuer
303090300MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20071008000131 FL Practitioner - Nurse Practitioner 0042305906 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Minuteclinic LLC Family CurrentSince Mar 29, 2015 Accepting new patients

Locations

121 W Macclenny Ave
Macclenny, FL 32063
Phone (904) 259-6380

12401 Miramar Pkwy
Miramar, FL 33027
Phone (954) 538-8473

8765 S Dixie Hwy
Pinecrest, FL 33156
Phone (305) 740-6840

7599 W Sand Lake Rd
Sand Lake, FL 32819
Phone (407) 352-0943

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1118361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519603200000",
    "number": "1629072293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1008 JENKS AVE",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324012437",
            "telephone_number": "850-215-3000",
            "fax_number": "850-215-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1008 JENKS AVE",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324012437",
            "telephone_number": "850-215-3000",
            "fax_number": "850-215-3000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 E 5th St",
            "address_purpose": "LOCATION",
            "city": "Chase City",
            "state": "VA",
            "postal_code": "23924",
            "country_code": "US",
            "telephone_number": "434-372-0900",
            "fax_number": "434-363-4258",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHADWICK",
        "first_name": "QUIN",
        "middle_name": "E",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-10",
        "last_updated": "2018-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "RN2911562",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024174353",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "303090300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Panama City, FL

Sources for this page

Verify at the official NPI Registry.