Individual provider Active NPI

Rebecca Leigh Quilliams, MSN, FNP-C, RN

  • Family Nurse Practitioner
  • Pigeon Forge, TN
National Provider Identifier
1710297809
Registry record updated Aug 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
30221 Issued in TN
Practice address
2656 Parkway Ste 4
Pigeon Forge, TN 37863-3392
Phone
(865) 366-3264
NPI assigned
Oct 7, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 29, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Registered Nurse 163WE0003X 0000165542 TN
Family Nurse Practitioner 363LF0000X 30221 TN Primary

Addresses

Primary practice location

2656 Parkway Ste 4
Pigeon Forge, TN 37863-3392

Mailing address

1022 Tittsworth Springs Rd
Seymour, TN 37865-6007
Phone (865) 640-1290

Other practice location 1

100 Cheyenne Ave
Lame Deer, MT 59043
Phone (406) 477-4400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20220621001923 TN Practitioner - Nurse Practitioner 1355720475 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
May accept Medicare assignment
Group practices
Urgent Care of the Smokies LLC.Group PAC ID 4183905292, 5 clinicians

Practice addresses (Care Compare)

1015 E Pkwy
Gatlinburg, TN 37738-5057

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
0000165542TNMDEmergency Registered Nurse

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": "1286409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630195200000",
    "number": "1710297809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1022 TITTSWORTH SPRINGS RD",
            "city": "SEYMOUR",
            "state": "TN",
            "postal_code": "378656007",
            "telephone_number": "865-640-1290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2656 PARKWAY STE 4",
            "city": "PIGEON FORGE",
            "state": "TN",
            "postal_code": "378633392",
            "telephone_number": "865-366-3264"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 CHEYENNE AVE",
            "address_purpose": "LOCATION",
            "city": "LAME DEER",
            "state": "MT",
            "postal_code": "59043",
            "country_code": "US",
            "telephone_number": "406-477-4400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "QUILLIAMS",
        "first_name": "REBECCA",
        "middle_name": "LEIGH",
        "name_prefix": "Ms.",
        "credential": "MSN, FNP-C, RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-10-07",
        "last_updated": "2021-08-29",
        "certification_date": "2021-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WE0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Emergency",
            "state": "TN",
            "license": "0000165542",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "30221",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pigeon Forge, TN

Sources for this page

Verify at the official NPI Registry.