Julie Barr Tedder Queen, P.A.-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0010-00820 Issued in NC

Practice address

200 Health Park Dr Ste 100
Garner, NC 27529-4679

Phone

(919) 773-1223

Fax

(919) 773-1955

NPI assigned

Feb 23, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Julie Barr Tedder Former name

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Brody School of Medicine at East Carolina University, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Garner Internal Medicine, P.a.Group PAC ID 1355330721, 11 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Interoperability endpoints

• Direct secure messaging: juliequeen@gim.allscriptsdirect.net

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.

• Garner Internal Medicine, P.a.

  • Primary Care Clinic/Center
  • Garner, NC
  • NPI 1679694665
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1172188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569974400000",
    "number": "1720113376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 HEALTH PARK DR STE 100",
            "city": "GARNER",
            "state": "NC",
            "postal_code": "275294679",
            "telephone_number": "919-773-1223",
            "fax_number": "919-773-1955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 HEALTH PARK DR STE 100",
            "city": "GARNER",
            "state": "NC",
            "postal_code": "275294679",
            "telephone_number": "919-773-1223",
            "fax_number": "919-773-1955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUEEN",
        "first_name": "JULIE",
        "middle_name": "BARR TEDDER",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-23",
        "last_updated": "2019-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-00820",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5902803",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JULIE",
            "last_name": "TEDDER",
            "middle_name": "BARR",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Physician Assistant in Garner, NC
• Providers in Garner, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2019; 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.
• 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.