Fasttrack Immediate Care of Milledgeville LLC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

FASTTRACK IMMEDIATE CARE OF MILLEDGEVILLE LLC

Practice address

1909 N Columbia St
Milledgeville, GA 31061-2170

Phone

(478) 295-3000

Fax

(478) 295-3003

NPI assigned

Oct 28, 2014

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

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

{
    "created_epoch": "1414454400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1366847790",
    "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": "1909 N COLUMBIA ST",
            "city": "MILLEDGEVILLE",
            "state": "GA",
            "postal_code": "310612170",
            "telephone_number": "478-295-3000",
            "fax_number": "478-295-3003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FASTTRACK IMMEDIATE CARE OF MILLEDGEVILLE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-28",
        "last_updated": "2022-07-21",
        "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": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.