Fasttrack Immediate Care, LLC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

FASTTRACK IMMEDIATE CARE, LLC

Practice address

126 N 2ND St
Cochran, GA 31014-6330

Phone

(478) 271-0337

Fax

(478) 295-3003

NPI assigned

Jan 26, 2016

Last updated

Nov 17, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Nicole Nobles Paulk

Title

Ceo

Phone

(478) 271-0337

Specialties & licenses 1

Addresses

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/58454b2e-331d-455c-9a19-f10338217401/

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

{
    "created_epoch": "1453766400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1542412800000",
    "number": "1326405044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "126 N 2ND ST",
            "city": "COCHRAN",
            "state": "GA",
            "postal_code": "310146330",
            "telephone_number": "478-271-0337",
            "fax_number": "478-295-3003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "126 N 2ND ST",
            "city": "COCHRAN",
            "state": "GA",
            "postal_code": "310146330",
            "telephone_number": "478-271-0337",
            "fax_number": "478-295-3003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FASTTRACK IMMEDIATE CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-26",
        "last_updated": "2018-11-17",
        "status": "A",
        "authorized_official_last_name": "PAULK",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_middle_name": "NOBLES",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "478-271-0337"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert Alan Dykes, PHARM D
• Guy T Easterling, DO
• Shemika N Elvine
• Melissa English, COTA
• Brenda R. Ethridge, GSL-SP.
• Melanie Yeomans Fish, M.ED., CCC-SLP
• Deananne D Fordham, PAC
• Lora Foskey, LMT
• Georgia CVS Pharmacy, L.L.C. (CVS Pharmacy #07200)
• Georgia Em-I Medical Service PC

• General Practice Physician in Cochran, GA
• Providers in Cochran, GA by specialty
• General Practice Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2018; 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.