NPIMap

Organization Active NPI

Community Quick Care

  • Non-Pharmacy Dispensing Site
  • Columbia, TN
National Provider Identifier
1083019608
Registry record updated Oct 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-Pharmacy Dispensing SiteTaxonomy code 332900000X
License
11494 Issued in TN
Legal business name
COMMUNITY QUICK CARE
Practice address
1412 Trotwood Avenue
Suite 39
Columbia, TN 38401
Phone
(931) 490-0832
Fax
(931) 490-0834
NPI assigned
Oct 24, 2014
Organization subpart
Yes
Parent organization
COMMUNITY QUICK CARE OF LAVERGNEAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 24, 2014

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

Authorized official

Name
Mr. Jerry Eledge, RPH
Title
Owner / Ceo
Phone
(931) 490-0832

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-Pharmacy Dispensing Site 332900000X 11494 TN Primary

Addresses

Primary practice location

1412 Trotwood Avenue
Suite 39
Columbia, TN 38401

Mailing address

1412 Trot Avenue
Suite 39
Columbia, TN 38401
Phone (931) 490-0832

Other names 1

  • Community Quick Care of Columbia Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Community Quick Care of Lavergne PC2 organizations share this tax ID, including this one
Part of
Community Quick Care of Lavergne PC

Other organizations with this tax ID 1

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

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IGFBAA

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1414108800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1414108800000",
    "number": "1083019608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1412 TROT AVENUE",
            "address_2": "SUITE 39",
            "city": "COLUMBIA",
            "state": "TN",
            "postal_code": "38401",
            "telephone_number": "931-490-0832",
            "fax_number": "931-490-0834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1412 TROTWOOD AVENUE",
            "address_2": "SUITE 39",
            "city": "COLUMBIA",
            "state": "TN",
            "postal_code": "38401",
            "telephone_number": "931-490-0832",
            "fax_number": "931-490-0834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY QUICK CARE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COMMUNITY QUICK CARE OF LAVERGNE",
        "enumeration_date": "2014-10-24",
        "last_updated": "2014-10-24",
        "status": "A",
        "authorized_official_last_name": "ELEDGE",
        "authorized_official_first_name": "JERRY",
        "authorized_official_title_or_position": "OWNER / CEO",
        "authorized_official_telephone_number": "931-490-0832",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "TN",
            "license": "11494",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Community Quick Care of Columbia",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Columbia, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2014; 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.