NPIMap

Organization Active NPI

Fast Pace Medical Clinic PLLC

  • Physical Therapist
  • Smithville, TN
National Provider Identifier
1073014643
Registry record updated Apr 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
FAST PACE MEDICAL CLINIC PLLC
Practice address
101 W Broad St
Smithville, TN 37166-1915
Phone
(855) 632-3278
Fax
(931) 722-9919
NPI assigned
Feb 28, 2018
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Robert Benson
Title
Coo
Phone
(931) 253-1110

National Provider Directory

National Provider Directory
Tax ID family
Fast Pace Medical Clinic PLLC133 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 21

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 21

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

NPPES NPI Registry

Primary practice location

101 W Broad St
Smithville, TN 37166-1915

Mailing address

PO Box 1258
Waynesboro, TN 38485-1258
Phone (931) 253-1110

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
1515574MedicaidTN

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Apr 22, 2021.

{
    "created_epoch": "1519776000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619049600000",
    "number": "1073014643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1258",
            "city": "WAYNESBORO",
            "state": "TN",
            "postal_code": "384851258",
            "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": "101 W BROAD ST",
            "city": "SMITHVILLE",
            "state": "TN",
            "postal_code": "371661915",
            "telephone_number": "855-632-3278",
            "fax_number": "931-722-9919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAST PACE MEDICAL CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-28",
        "last_updated": "2021-04-22",
        "certification_date": "2021-04-22",
        "status": "A",
        "authorized_official_last_name": "BENSON",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "931-253-1110"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1515574",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Smithville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 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.