Active NPI
Kullen Quinlan
- Occupational Therapist
- Fort Wayne, IN
National Provider Identifier
1760802516
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 31005661A
- Practice address
- 2237 Engle Rd
Fort Wayne, IN 46809-1404 - Phone
- (260) 747-2353
- NPI assigned
- Apr 20, 2014
- Last updated
- Apr 20, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 31005661A | IN | Primary |
Addresses
Primary practice location
2237 Engle Rd
Fort Wayne, IN 46809-1404
Mailing address
2237 Engle Rd
Fort Wayne, IN 46809-1404
Phone (260) 747-2353
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 31005661A | IN | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1397952000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1397952000000",
"number": "1760802516",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2237 ENGLE RD",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468091404",
"telephone_number": "260-747-2353"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2237 ENGLE RD",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468091404",
"telephone_number": "260-747-2353"
}
],
"practiceLocations": [],
"basic": {
"last_name": "QUINLAN",
"first_name": "KULLEN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-04-20",
"last_updated": "2014-04-20",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "IN",
"license": "31005661A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Wayne, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.