Individual provider Active NPI

Daniel Robert Quinlan, OD

  • Optometrist
  • Paducah, KY
National Provider Identifier
1851435366
Registry record updated Jan 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
913DT Issued in KY
Practice address
609 Broadway
Paducah, KY 42002
Phone
(270) 443-3202
Fax
(270) 443-3202
NPI assigned
Feb 16, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 23, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 913DT KY Primary

Addresses

Primary practice location

609 Broadway
Paducah, KY 42002

Mailing address

609 Broadway
PO Box 1036
Paducah, KY 42002
Phone (270) 443-3202

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

State licenses

LicenseStateTypeSpecialty
913DTKYMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1171584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1232668800000",
    "number": "1851435366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "609 BROADWAY",
            "address_2": "PO BOX 1036",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "42002",
            "telephone_number": "270-443-3202",
            "fax_number": "270-443-3202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "609 BROADWAY",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "42002",
            "telephone_number": "270-443-3202",
            "fax_number": "270-443-3202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUINLAN",
        "first_name": "DANIEL",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-16",
        "last_updated": "2009-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KY",
            "license": "913DT",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Paducah, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2009; 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.