Organization Active NPI

Express Lane Urgent Care Inc.

  • Urgent Care Clinic/Center
  • Turlock, CA
National Provider Identifier
1104075522
Registry record updated May 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
EXPRESS LANE URGENT CARE INC.
Practice address
711 E Hawkeye Ave
Suite #3
Turlock, CA 95380-7505
Phone
(209) 664-1550
Fax
(209) 664-1548
NPI assigned
Sep 9, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 19, 2015

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

Authorized official

Name
Paul AndersonNPI 1184605396
Title
Physician Assistant
Phone
(209) 664-1550

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X Primary

Addresses

Primary practice location

711 E Hawkeye Ave
Suite #3
Turlock, CA 95380-7505

Mailing address

711 E Hawkeye Ave
Suite #3
Turlock, CA 95380-7505
Phone (209) 664-1550

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090319000670 CA Part B Supplier - Clinic/Group Practice 3779640669 Receives reassigned benefits from 3 practitioners
Practice locations: Turlock, CA

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
05D2096037Express Lane Urgent Care711 E Hawkeye Ave Ste 3, Turlock, CA 95380Certificate of waiverMay 13, 2027

National Provider Directory

National Provider Directory

Locations

711 E Hawkeye Ave
Ste 3
Turlock, CA 95380
Phone (209) 664-1550

711 E Hawkeye Ave
Turlock, CA 95380

Practitioners & affiliated clinicians

Practitioners 5

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

NPI Registry JSON

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

{
    "created_epoch": "1220918400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1431993600000",
    "number": "1104075522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 E HAWKEYE AVE",
            "address_2": "SUITE #3",
            "city": "TURLOCK",
            "state": "CA",
            "postal_code": "953807505",
            "telephone_number": "209-664-1550",
            "fax_number": "209-664-1548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 E HAWKEYE AVE",
            "address_2": "SUITE #3",
            "city": "TURLOCK",
            "state": "CA",
            "postal_code": "953807505",
            "telephone_number": "209-664-1550",
            "fax_number": "209-664-1548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXPRESS LANE URGENT CARE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-09",
        "last_updated": "2015-05-19",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "PHYSICIAN ASSISTANT",
        "authorized_official_telephone_number": "209-664-1550"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Turlock, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2015; 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.