NPIMap

Organization Active NPI

Fastmed Holdings, PLLC

  • Family Medicine Physician
  • Clayton, NC
National Provider Identifier
1154880813
Registry record updated Mar 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
FASTMED HOLDINGS, PLLC
Practice address
11491 US Highway 70, West
Suite B
Clayton, NC 27520-5598
Phone
(919) 550-2584
Fax
(919) 550-7059
NPI assigned
Mar 13, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2019

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

Authorized official

Name
Shelley Jane Staymates
Title
Nat. Credentialing Manager
Phone
(480) 500-2285

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X

Addresses

Primary practice location

11491 US Highway 70, West
Suite B
Clayton, NC 27520-5598

Mailing address

935 Shotwell Rd Ste 108
Clayton, NC 27520-5598
Phone (919) 550-2584

Other names 1

  • FastMed Health, PLLC Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address s.staymates@fastmed.com Direct

National Provider Directory

National Provider Directory
Tax ID family
Fastmed Health NC PLLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

NPI Registry JSON

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

{
    "created_epoch": "1552435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1552435200000",
    "number": "1154880813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "935 SHOTWELL RD STE 108",
            "city": "CLAYTON",
            "state": "NC",
            "postal_code": "275205598",
            "telephone_number": "919-550-2584",
            "fax_number": "919-882-9575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11491 US HIGHWAY 70, WEST",
            "address_2": "SUITE B",
            "city": "CLAYTON",
            "state": "NC",
            "postal_code": "275205598",
            "telephone_number": "919-550-2584",
            "fax_number": "919-550-7059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FASTMED HOLDINGS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-13",
        "last_updated": "2019-03-13",
        "status": "A",
        "authorized_official_last_name": "STAYMATES",
        "authorized_official_first_name": "SHELLEY",
        "authorized_official_middle_name": "JANE",
        "authorized_official_title_or_position": "NAT. CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "480-500-2285"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "s.staymates@fastmed.com",
            "affiliation": "N",
            "endpointDescription": "s.staymates@fastmed.com",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "935 Shotwell Rd Ste 108",
            "city": "Clayton",
            "state": "NC",
            "country_code": "US",
            "postal_code": "275205598",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "FastMed Health, PLLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Clayton, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2019; 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.