NPIMap

Organization Active NPI

Quintessential Wellness

  • Medical Specialty Clinic/Center
  • Clayton, NC
National Provider Identifier
1972983286
Registry record updated Aug 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
License
3960 Issued in NC
Legal business name
QUINTESSENTIAL WELLNESS
Practice address
620 NC Highway 42 W
Clayton, NC 27520-5803
Phone
(919) 400-7909
Fax
(919) 243-0530
NPI assigned
Jun 2, 2015
Last updated
Aug 13, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2015

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

Authorized official

Name
Amanda R Keates, D.CNPI 1396731907
Title
Owner
Phone
(919) 400-7909

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X 3960 NC Primary

Addresses

Primary practice location

620 NC Highway 42 W
Clayton, NC 27520-5803

Mailing address

620 NC Highway 42 W
Clayton, NC 27520-5803
Phone (919) 400-7909

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1433203200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1439424000000",
    "number": "1972983286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 NC HIGHWAY 42 W",
            "city": "CLAYTON",
            "state": "NC",
            "postal_code": "275205803",
            "telephone_number": "919-400-7909",
            "fax_number": "919-243-0530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 NC HIGHWAY 42 W",
            "city": "CLAYTON",
            "state": "NC",
            "postal_code": "275205803",
            "telephone_number": "919-400-7909",
            "fax_number": "919-243-0530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUINTESSENTIAL WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-02",
        "last_updated": "2015-08-13",
        "status": "A",
        "authorized_official_last_name": "KEATES",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "919-400-7909",
        "authorized_official_credential": "D.C"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "NC",
            "license": "3960",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clayton, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2015; 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.