Quality Primary Care Corporation

Primary specialty

Urgent Care Clinic/CenterTaxonomy code 261QU0200X

Legal business name

QUALITY PRIMARY CARE CORPORATION

Practice address

135 W Perry St
Port Clinton, OH 43452-1010

Phone

(419) 732-7800

Fax

(419) 797-4843

NPI assigned

Apr 23, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Richard L Kendall, MDNPI 1285648097

Title

President

Phone

(419) 732-7800

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Fastrack Urgent Care Corporation Doing business as

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

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

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Richard L Kendall, MD

  • Emergency Medicine Physician
  • Port Clinton, OH
  • NPI 1285648097
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1208908800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1355443200000",
    "number": "1043485808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 W PERRY ST",
            "city": "PORT CLINTON",
            "state": "OH",
            "postal_code": "434521010",
            "telephone_number": "419-732-7800",
            "fax_number": "419-797-4843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 W PERRY ST",
            "city": "PORT CLINTON",
            "state": "OH",
            "postal_code": "434521010",
            "telephone_number": "419-732-7800",
            "fax_number": "419-797-4843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUALITY PRIMARY CARE CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-23",
        "last_updated": "2012-12-14",
        "status": "A",
        "authorized_official_last_name": "KENDALL",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "419-732-7800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN (PART B - PTAN)",
            "identifier": "9375701",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DUNS NUMBER",
            "identifier": "002026190",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2847727",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fastrack Urgent Care Corporation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Nathaniel Joseph Puchala, IDHS
• Leonardo T Que, M.D.
• Virgie U Que, M.D.
• Kristen Marie Quisno-Witt, CCC-SLP
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• Kevindeep Raju, PHARMD

• Urgent Care Clinic/Center in Port Clinton, OH
• Providers in Port Clinton, OH by specialty
• Urgent Care Clinic/Center in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.