Kelly Quinn, FNP-C

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

5004545 Issued in NC

Practice address

1900 Randolph Rd Ste 1016
Charlotte, NC 28207

Phone

(704) 347-3447

Fax

(704) 347-3440

NPI assigned

Oct 30, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 4

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kelly.quinn.1@16710.direct.athenahealth.com
• FHIR API: https://fhir4.healow.com/fhir/r4/GGICCA

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.

• Carolina Pain and Weight Loss

  • Pain Medicine Physician
  • Mooresville, NC
  • NPI 1598101974

  Nurse Practitioner

  Medicare reassignment NPD
• Carolina Pain and Weight Loss, PA

  • Pain Medicine Physician
  • Salisbury, NC
  • NPI 1932936226

  Nurse Practitioner

  NPD
• Geode Health of North Carolina, PLLC

  • Psychiatry Physician
  • Durham, NC
  • NPI 1588433502
  NPD

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

{
    "created_epoch": "1256860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563148800000",
    "number": "1720314420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1844",
            "city": "BRYSON CITY",
            "state": "NC",
            "postal_code": "287131844",
            "telephone_number": "828-785-5301",
            "fax_number": "828-538-4441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 RANDOLPH RD STE 1016",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "28207",
            "telephone_number": "704-347-3447",
            "fax_number": "704-347-3440"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1224 Commerce St SW Ste A",
            "address_purpose": "LOCATION",
            "city": "Conover",
            "state": "NC",
            "postal_code": "286138245",
            "country_code": "US",
            "telephone_number": "828-261-0467",
            "fax_number": "828-267-0599",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1035 Lincolnton Rd",
            "address_purpose": "LOCATION",
            "city": "Salisbury",
            "state": "NC",
            "postal_code": "281446277",
            "country_code": "US",
            "telephone_number": "704-637-5767",
            "fax_number": "704-637-5786",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "QUINN",
        "first_name": "KELLY",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-30",
        "last_updated": "2019-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5004545",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5004545",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "9242002",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS NC",
            "identifier": "169PA",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "NCH095C",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P02008773",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Thomas Frederic Quine, PT
• Devon Quinn, LMFT-A
• Dorian Quinn
• Grea Quinn
• Jacqueline Ann Quinn, PA
• Laura Quinn, LCSW-A, LMSW
• Madalyn Quinn, RD, LDN
• Milan Tryshae Quinn
• Grace Elizabeth Quinney, PHYSICIAN ASSISTANT
• Fabiola Nicohl Quinones Rosa, RD

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.