Active NPI
Quiawanna Dallas
- Psychiatric/Mental Health Nurse Practitioner
- Birmingham, AL
National Provider Identifier
1851147458
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- 1-182128
- Practice address
- 2100 Southbridge Pkwy Ste 650
Birmingham, AL 35209-1317 - Phone
- (646) 941-7645
- Fax
- (929) 596-7897
- NPI assigned
- Apr 25, 2024
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 1-182128 | AL | Primary |
Addresses
Primary practice location
2100 Southbridge Pkwy Ste 650
Birmingham, AL 35209-1317
Mailing address
2779 Southwood LN
Bessemer, AL 35022-5692
Phone (205) 644-3328
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1714003200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1714003200000",
"number": "1851147458",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2779 SOUTHWOOD LN",
"city": "BESSEMER",
"state": "AL",
"postal_code": "350225692",
"telephone_number": "205-644-3328"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2100 SOUTHBRIDGE PKWY STE 650",
"city": "BIRMINGHAM",
"state": "AL",
"postal_code": "352091317",
"telephone_number": "646-941-7645",
"fax_number": "929-596-7897"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DALLAS",
"first_name": "QUIAWANNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-04-25",
"last_updated": "2024-04-25",
"certification_date": "2024-04-25",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "AL",
"license": "1-182128",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Birmingham, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2024; 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.