Active NPI
Amber Davis Quinn
- Occupational Therapy Assistant
- Kenansville, NC
National Provider Identifier
1861040792
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 6176
- Practice address
- 209 Beasley Street
Kenansville, NC 28349-8727 - Phone
- (910) 296-1561
- NPI assigned
- Sep 4, 2019
- 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 |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 6176 | NC | Primary |
Addresses
Primary practice location
209 Beasley Street
Kenansville, NC 28349-8727
Mailing address
209 Beasley St
Kenansville, NC 28349-8727
Phone (910) 296-1561
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 |
|---|---|---|---|
| 6176 | NC | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1567555200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1567555200000",
"number": "1861040792",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "209 BEASLEY ST",
"city": "KENANSVILLE",
"state": "NC",
"postal_code": "283498727",
"telephone_number": "910-296-1561"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "209 BEASLEY STREET",
"city": "KENANSVILLE",
"state": "NC",
"postal_code": "283498727",
"telephone_number": "910-296-1561"
}
],
"practiceLocations": [],
"basic": {
"last_name": "QUINN",
"first_name": "AMBER",
"middle_name": "DAVIS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-09-04",
"last_updated": "2019-09-04",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "NC",
"license": "6176",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kenansville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.