Raquel Quevedo, MSN, NP-C

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

5020617 Issued in NC

Practice address

6911 Lakeside Dr
Charlotte, NC 28215-4018

Phone

(203) 893-2864

NPI assigned

Aug 31, 2012

Last updated

Sep 18, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing

State licenses

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

{
    "created_epoch": "1346371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726617600000",
    "number": "1689923054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6911 LAKESIDE DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282154018",
            "telephone_number": "203-893-2864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6911 LAKESIDE DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282154018",
            "telephone_number": "203-893-2864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUEVEDO",
        "first_name": "RAQUEL",
        "credential": "MSN, NP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-08-31",
        "last_updated": "2024-09-18",
        "certification_date": "2024-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NC",
            "license": "5020617",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71004072A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Primary Care Nurse Practitioner in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Primary Care Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.