NPIMap

Organization Active NPI

Fast Pace Kentucky PLLC

  • Rural Health Clinic/Center
  • Madisonville, KY
National Provider Identifier
1003537853
Registry record updated Jan 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
FAST PACE KENTUCKY PLLC
Practice address
1350 N Main St
Madisonville, KY 42431-1282
Phone
(502) 337-7409
NPI assigned
Sep 9, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2025

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

Authorized official

Name
Christy Littlejohn
Title
Manager
Phone
(931) 981-1901

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

1350 N Main St
Madisonville, KY 42431-1282

Mailing address

PO Box 306414
Nashville, TN 37230-6414
Phone (931) 253-1110

Other names 1

  • Fast Pace Health Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250306002034 KY Part A Provider - Rural Health Clinic 0143525998 Practice locations: Madisonville, KY

Rural health clinic certification: CCN B03904

Legal name
FAST PACE KENTUCKY, PLLC
Doing business as
FAST PACE HEALTH
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Nov 18, 2022
Last certification
Nov 18, 2022
Ownership / control type
1B
Organization structure
OtherProprietary
Enrollment address
1350 N Main St
Madisonville, KY 42431-1282

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
18D2115139Fast Pace Kentucky PLLC1350 N Main St, Madisonville, KY 42431Certificate of waiverJun 28, 2028

National Provider Directory

National Provider Directory
Tax ID family
Fast Pace Kentucky PLLC42 organizations share this tax ID, including this one

Other organizations with this tax ID 41

Organizations that report the same tax identification number in the National Provider Directory.

View all 41

Ownership & related parties

All disclosed owners & managing parties 5

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Melissa Harlan Individual Operational/Managerial ControlDirector Jan 1, 2024 100%
Barry Louis Taylor Individual 5% Or Greater Direct Ownership InterestOwner May 1, 2019 33.3%
Christy Littlejohn Individual Operational/Managerial ControlManager Jan 1, 2024 100%
Karen Denise Daingerfield Individual 5% Or Greater Direct Ownership InterestOwner May 1, 2019 33.3%
Dana Kay Martin Individual 5% Or Greater Direct Ownership InterestOwner May 1, 2019 33.3%

Owners & managing parties with NPI records 3

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Change-of-ownership history 2

DateEventCounterparty
Mar 31, 2025 Change of OwnershipThis provider was the buyer Brock Medical, LLCCCN B03904, KY, NPI 1003537853
Mar 31, 2025 Change of OwnershipThis provider was the seller Fast Pace HealthCCN B03904, KY, NPI 1003537853

NPI Registry JSON

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

{
    "created_epoch": "1662681600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737072000000",
    "number": "1003537853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 306414",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372306414",
            "telephone_number": "931-253-1110",
            "fax_number": "931-722-9919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 N MAIN ST",
            "city": "MADISONVILLE",
            "state": "KY",
            "postal_code": "424311282",
            "telephone_number": "502-337-7409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAST PACE KENTUCKY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-09",
        "last_updated": "2025-01-17",
        "certification_date": "2025-01-17",
        "status": "A",
        "authorized_official_last_name": "LITTLEJOHN",
        "authorized_official_first_name": "CHRISTY",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "931-981-1901"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fast Pace Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Madisonville, KY

Sources for this page

Verify at the official NPI Registry.