Individual provider Active NPI

Cindy Renee' Quinn, FNP-C

  • Nurse Practitioner
  • Meridian, MS
National Provider Identifier
1881207918
Registry record updated Sep 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
904094 Issued in MS
Practice address
1314 19TH Ave
Meridian, MS 39301-4195
Phone
(601) 703-0260
NPI assigned
Aug 28, 2020
Last updated
Sep 3, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 904094 MS Primary

Addresses

Primary practice location

1314 19TH Ave
Meridian, MS 39301-4195

Mailing address

5464 Vimville Causeyville Rd
Meridian, MS 39301-7507
Phone (601) 481-5630

Other practice location 1

1710 14th St
Meridian, MS 39301-4140
Phone (601) 482-0900

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL Rushhealthsystems.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201012002484 MS Practitioner - Nurse Practitioner 6204256365 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bonita Emergency Group LLCGroup PAC ID 3870933278, 26 clinicians
Medical Foundation IncGroup PAC ID 9234043712, 211 clinicians

Practice addresses (Care Compare)

1314 19TH Ave
Meridian, MS 39301-4116
Phone (601) 483-0011

1800 12TH St
Meridian, MS 39301-4158
Phone (601) 484-6700

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
904094MSMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bonita Emergency Group, LLC Nurse Practitioner CurrentSince May 13, 2024 Accepting new patients

Locations

1314 19th Ave
Meridian, MS 39301
Phone (601) 483-0011

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1598572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599091200000",
    "number": "1881207918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5464 VIMVILLE CAUSEYVILLE RD",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393017507",
            "telephone_number": "601-481-5630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1314 19TH AVE",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393014195",
            "telephone_number": "601-703-0260"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1710 14th St",
            "address_purpose": "LOCATION",
            "city": "Meridian",
            "state": "MS",
            "postal_code": "393014140",
            "country_code": "US",
            "telephone_number": "601-482-0900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "QUINN",
        "first_name": "CINDY",
        "middle_name": "RENEE'",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-28",
        "last_updated": "2020-09-03",
        "certification_date": "2020-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MS",
            "license": "904094",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Rushhealthsystems.org",
            "affiliation": "N",
            "address_1": "1710 14th St",
            "city": "Meridian",
            "state": "MS",
            "country_code": "US",
            "postal_code": "393014140",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Meridian, MS

Sources for this page

Verify at the official NPI Registry.