Individual provider Active NPI

Thomas Joseph Quinn, M.D.

  • Surgery Physician
  • Traverse City, MI
National Provider Identifier
1730171570
Registry record updated Mar 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
TQ035293 Issued in MI
Practice address
1221 6TH St
Suite 306
Traverse City, MI 49684-2359
Phone
(231) 935-2400
Fax
(231) 935-2424
NPI assigned
Aug 18, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X TQ035293 MI Primary

Addresses

Primary practice location

1221 6TH St
Suite 306
Traverse City, MI 49684-2359

Mailing address

1221 6TH St
Suite 306
Traverse City, MI 49684-2359
Phone (231) 935-2400

Other identifiers 1

IdentifierTypeStateIssuer
1306453MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
TQ035293MIMDSurgery Physician

NPI Registry JSON

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

{
    "created_epoch": "1124323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205107200000",
    "number": "1730171570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1221 6TH ST",
            "address_2": "SUITE 306",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496842359",
            "telephone_number": "231-935-2400",
            "fax_number": "231-935-2424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 6TH ST",
            "address_2": "SUITE 306",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496842359",
            "telephone_number": "231-935-2400",
            "fax_number": "231-935-2424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUINN",
        "first_name": "THOMAS",
        "middle_name": "JOSEPH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-18",
        "last_updated": "2008-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MI",
            "license": "TQ035293",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1306453",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Traverse City, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.