Organization Active NPI

Quickmd Medical Group PA

  • Internal Medicine Physician
  • Las Vegas, NV
National Provider Identifier
1356061881
Registry record updated Jan 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
QUICKMD MEDICAL GROUP PA
Practice address
504 San Pablo Dr Apt 202
Las Vegas, NV 89104-2737
Phone
(888) 878-4256
NPI assigned
Sep 2, 2022
Last updated
Jan 15, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2024

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

Authorized official

Name
Katrina Merritt
Title
Senior Manager, Credentialing
Phone
(813) 596-5726

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Psychologist 103TA0400X NU
Internal Medicine Physician 207R00000X NU Primary
Addiction Medicine (Psychiatry & Neurology) Physician 2084A0401X NU
General Practice Physician 208D00000X NU

Addresses

Primary practice location

504 San Pablo Dr Apt 202
Las Vegas, NV 89104-2737

Mailing address

3865 Holcomb Bridge Rd
Peachtree Corners, GA 30092-2205
Phone (888) 878-4256

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1662076800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705276800000",
    "number": "1356061881",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3865 HOLCOMB BRIDGE RD",
            "city": "PEACHTREE CORNERS",
            "state": "GA",
            "postal_code": "300922205",
            "telephone_number": "888-878-4256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "504 SAN PABLO DR APT 202",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891042737",
            "telephone_number": "888-878-4256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUICKMD MEDICAL GROUP PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-02",
        "last_updated": "2024-01-15",
        "certification_date": "2024-01-15",
        "status": "A",
        "authorized_official_last_name": "MERRITT",
        "authorized_official_first_name": "KATRINA",
        "authorized_official_title_or_position": "SENIOR MANAGER, CREDENTIALING",
        "authorized_official_telephone_number": "813-596-5726"
    },
    "taxonomies": [
        {
            "code": "103TA0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "2084A0401X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2024; 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.