Individual provider Active NPI

Angela Quick, FNP

  • Family Nurse Practitioner
  • Dyersburg, TN
National Provider Identifier
1902451446
Registry record updated Apr 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
25838 Issued in TN
Practice address
420 Wilkinson Dr
Dyersburg, TN 38024-2085
Phone
(731) 285-5133
NPI assigned
Aug 1, 2019
Last updated
Apr 11, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 25838 TN Primary

Addresses

Primary practice location

420 Wilkinson Dr
Dyersburg, TN 38024-2085

Mailing address

176 Highway 210 S
Dyersburg, TN 38024-8228

Other practice location 1

143 Kennedy Dr
Martin, TN 38237-3309
Phone (731) 285-5133

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20191029002451 TN Practitioner - Nurse Practitioner 1759613490 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
WT Medical AssociatesGroup PAC ID 1951650613, 64 clinicians
West Tennessee Medical Group IncGroup PAC ID 3971781006, 190 clinicians

Practice addresses (Care Compare)

164 Mount Pelia Rd
Martin, TN 38237-3812
Phone (731) 285-5133

1716 Parr Ave
Suite C
Dyersburg, TN 38024-2074
Phone (731) 421-6510

620 Skyline Dr
Jackson, TN 38301-3923
Phone (731) 541-5000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25838TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dyersburg Family Walk-in Clinic LLC CurrentSince Aug 17, 2019 Accepting new patients
WT Medical Associates Family CurrentSince Dec 1, 2021 Accepting new patients
WT Medical Associates CurrentSince Dec 1, 2021 Accepting new patients

Locations

1954 Saint John Ave
Ste 1
Dyersburg, TN 38024
Phone (731) 285-6110

2017 Saint John Ave
Ste B
Dyersburg, TN 38024
Phone (731) 285-6110

420 Wilkinson Dr
Fl 2
Dyersburg, TN 38024
Phone (731) 285-5133

1804 Highway 45 Byp
Ste 604
Jackson, TN 38305
Phone (731) 512-1273

143 Kennedy Dr
Martin, TN 38237
Phone (731) 587-5321

164 Mount Pelia Rd
Martin, TN 38237
Phone (731) 587-5900

Interoperability endpoints

  • Direct secure messaging: aquick22021@directepic.wth.org

Organizations & group practices 4

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": "1564617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681171200000",
    "number": "1902451446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "176 HIGHWAY 210 S",
            "city": "DYERSBURG",
            "state": "TN",
            "postal_code": "380248228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 WILKINSON DR",
            "city": "DYERSBURG",
            "state": "TN",
            "postal_code": "380242085",
            "telephone_number": "731-285-5133"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "143 Kennedy Dr",
            "address_purpose": "LOCATION",
            "city": "Martin",
            "state": "TN",
            "postal_code": "382373309",
            "country_code": "US",
            "telephone_number": "731-285-5133",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "QUICK",
        "first_name": "ANGELA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-01",
        "last_updated": "2023-04-11",
        "certification_date": "2023-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "25838",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dyersburg, TN

Sources for this page

Verify at the official NPI Registry.