Individual provider Active NPI

Thomas C Quesnell, M.S.

  • Audiologist
  • Davenport, IA
National Provider Identifier
1639397029
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
415 Issued in IA
Practice address
1227 E Rusholme St
Dept of Speech and Hearing
Davenport, IA 52803-2459
Phone
(563) 421-1400
Fax
(563) 421-1410
NPI assigned
Apr 23, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 415 IA Primary

Addresses

Primary practice location

1227 E Rusholme St
Dept of Speech and Hearing
Davenport, IA 52803-2459

Mailing address

1915 18TH St
Bettendorf, IA 52722-3716
Phone (563) 421-1400

Other identifiers 1

IdentifierTypeStateIssuer
717OtherIAHEARING AID DEALER LIC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA, IL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20171201001366 IA Practitioner - Qualified Audiologist 5890052716 Reassigns benefits to 1 organization
I20180809006175 IL Practitioner - Qualified Audiologist 5890052716 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
ENT Professional Services PCGroup PAC ID 8426949298, 9 clinicians

Practice addresses (Care Compare)

3385 Dexter CT
Suite 101
Davenport, IA 52807-3471
Phone (563) 359-1646

600 John Deere Rd
Suite 400
Moline, IL 61265-6812
Phone (563) 359-1646

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
415IAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
ENT Professional Services, PC CurrentSince Aug 1, 2018 Accepting new patients
ENT Hearing AIDS, LLC Audiologist Past Accepting new patients

Locations

3385 Dexter Ct
Ste 101
Davenport, IA 52807
Phone (319) 359-1646

600 John Deere Rd
Ste 400
Moline, IL 61265
Phone (309) 779-4600

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.441.237

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1639397029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1915 18TH ST",
            "city": "BETTENDORF",
            "state": "IA",
            "postal_code": "527223716",
            "telephone_number": "563-421-1400",
            "fax_number": "563-421-1410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1227 E RUSHOLME ST",
            "address_2": "DEPT OF SPEECH AND HEARING",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528032459",
            "telephone_number": "563-421-1400",
            "fax_number": "563-421-1410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUESNELL",
        "first_name": "THOMAS",
        "middle_name": "C",
        "credential": "M.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "IA",
            "license": "415",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEARING AID DEALER LIC",
            "identifier": "717",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Davenport, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.