Fast Pace Mississippi, PLLC

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

FAST PACE MISSISSIPPI, PLLC

Practice address

1709 W Quitman St
Iuka, MS 38852-7365

Phone

(901) 351-1791

NPI assigned

Jul 1, 2021

Organization subpart

No

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

Authorized official

Name

Sydni Clemmons

Title

Credentialing Manager

Phone

(901) 351-1791

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1625097600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1625097600000",
    "number": "1023688918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 306415",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372306415",
            "telephone_number": "901-351-1791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1709 W QUITMAN ST",
            "city": "IUKA",
            "state": "MS",
            "postal_code": "388527365",
            "telephone_number": "901-351-1791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAST PACE MISSISSIPPI, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-01",
        "last_updated": "2021-07-01",
        "certification_date": "2021-07-01",
        "status": "A",
        "authorized_official_last_name": "CLEMMONS",
        "authorized_official_first_name": "SYDNI",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "901-351-1791"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID PENDING",
            "identifier": "0000",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Drayer Physical Therapy of Tennessee LLC
• James Dye, CMHT
• Rollin Fair, DPT
• Family Home Care, Inc.
• Family Home Care, Inc.
• Fast Pace Mississippi, PLLC
• Felix Morris M.D., LLC
• Devin I Ferrell, OTA
• Chad Everett Fisher
• Morgan Franklin

• Specialist in Iuka, MS
• Providers in Iuka, MS by specialty
• Specialist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2021; 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.