Individual provider Active NPI

Diana Rebeca Quintero, MD

  • Pediatric Pulmonology Physician
  • Knoxville, TN
National Provider Identifier
1992759906
Registry record updated Apr 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Pulmonology PhysicianTaxonomy code 2080P0214X
License
55906 Issued in TN
Practice address
2018 Clinch Avenue
South Tower 1St Floor
Knoxville, TN 37916-3791
Phone
(865) 637-8481
Fax
(865) 246-7560
NPI assigned
May 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Pulmonology Physician 2080P0214X 55906 TN Primary

Addresses

Primary practice location

2018 Clinch Avenue
South Tower 1St Floor
Knoxville, TN 37916-3791

Mailing address

PO Box 15004
Knoxville, TN 37901-5004
Phone (865) 541-8895

Other practice location 1

207 E Emory Rd
Powell, TN 37849-4047
Phone (865) 637-8481

Other practice location 2

502 Winfield Dunn Pkwy
Sevierville, TN 37876-5509
Phone (865) 637-8481

Other practice location 3

1025 Childrens Way
Knoxville, TN 37922-7713
Phone (865) 637-8481

Other identifiers 1

IdentifierTypeStateIssuer
Q029278MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100803000929 WI Practitioner - Pulmonary DiseasePractitioner - Pediatric Medicine 2365575966 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
55906TNMDPediatric Pulmonology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Medical College of Wisconsin, Inc. CurrentSince Jul 1, 2002 Accepting new patients
East Tennessee Children'S Hospital Association, Inc. Pediatrics Past Accepting new patients

Locations

10911 N Port Washington Rd
Mequon, WI 53092
Phone (262) 241-2080

Bin 88350
Milwaukee, WI 53288
Phone (414) 805-3122

8701 Watertown Plank Rd
Wauwatosa, WI 53226
Phone (414) 456-4100

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1148256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649376000000",
    "number": "1992759906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 15004",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379015004",
            "telephone_number": "865-541-8895",
            "fax_number": "865-633-4808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2018 CLINCH AVENUE",
            "address_2": "SOUTH TOWER 1ST FLOOR",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379163791",
            "telephone_number": "865-637-8481",
            "fax_number": "865-246-7560"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "207 E Emory Rd",
            "address_purpose": "LOCATION",
            "city": "Powell",
            "state": "TN",
            "postal_code": "378494047",
            "country_code": "US",
            "telephone_number": "865-637-8481",
            "fax_number": "865-246-7560",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "502 Winfield Dunn Pkwy",
            "address_purpose": "LOCATION",
            "city": "Sevierville",
            "state": "TN",
            "postal_code": "378765509",
            "country_code": "US",
            "telephone_number": "865-637-8481",
            "fax_number": "865-246-7560",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1025 Childrens Way",
            "address_purpose": "LOCATION",
            "city": "Knoxville",
            "state": "TN",
            "postal_code": "379227713",
            "country_code": "US",
            "telephone_number": "865-637-8481",
            "fax_number": "865-246-7560",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "QUINTERO",
        "first_name": "DIANA",
        "middle_name": "REBECA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-22",
        "last_updated": "2022-04-08",
        "certification_date": "2022-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0214X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Pulmonology",
            "state": "TN",
            "license": "55906",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q029278",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

Verify at the official NPI Registry.