Kip Edward Queenan, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

L5520 Issued in TX

Practice address

2401 E Street M/Med/DMD/QM Sa-1
Washington, DC 20522-0102

Phone

(202) 663-1534

NPI assigned

Apr 4, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1144108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577318400000",
    "number": "1962464024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 E STREET M/MED/DMD/QM SA-1",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "205220102",
            "telephone_number": "202-663-1534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 E STREET M/MED/DMD/QM SA-1",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "205220102",
            "telephone_number": "202-663-1534"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16479 Dallas Pkwy",
            "address_2": "Suite 320",
            "address_purpose": "LOCATION",
            "city": "Addison",
            "state": "TX",
            "postal_code": "750016825",
            "country_code": "US",
            "telephone_number": "469-484-4264",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "QUEENAN",
        "first_name": "KIP",
        "middle_name": "EDWARD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-04",
        "last_updated": "2019-12-26",
        "certification_date": "2019-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TX",
            "license": "L5520",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marialori C Queen
• Sherri Queen
• Shonnise Queen
• Tamika Queen, MD
• Queen'S Vision Inc
• Fuah Anye Queenta
• Queenvision Health Services LLC
• Gabriella Kristina Quevedo, DMD
• Augusto Rene Quezada
• Freesia Quezada, MD

• Psychiatry Physician in Washington, DC
• Providers in Washington, DC by specialty
• Psychiatry Physician in District of Columbia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 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.

Verify at the official NPI Registry.