Organization Active NPI

Quick Care Clinic LLC

  • Primary Care Clinic/Center
  • Grenada, MS
National Provider Identifier
1386035202
Registry record updated Feb 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
QUICK CARE CLINIC LLC
Practice address
350 Sunset Dr
Grenada, MS 38901-4613
Phone
(662) 307-2750
Fax
(662) 307-2438
NPI assigned
Feb 13, 2015
Last updated
Feb 13, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2015

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

Authorized official

Name
Salina Blankenship, FNP
Title
Clinic Manager
Phone
(662) 307-2750

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X NU Primary

Addresses

Primary practice location

350 Sunset Dr
Grenada, MS 38901-4613

Mailing address

350 Sunset Dr
Grenada, MS 38901-4613
Phone (662) 307-2750

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150619001722 MS Part B Supplier - Clinic/Group Practice 2961713748 Receives reassigned benefits from 5 practitioners
Practice locations: Grenada, MS

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
25D2091955Quick Care Clinic, LLC350 Sunset Drive, Grenada, MS 38901Certificate of waiverFeb 22, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1423785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1423785600000",
    "number": "1386035202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 SUNSET DR",
            "city": "GRENADA",
            "state": "MS",
            "postal_code": "389014613",
            "telephone_number": "662-307-2750",
            "fax_number": "662-307-2438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 SUNSET DR",
            "city": "GRENADA",
            "state": "MS",
            "postal_code": "389014613",
            "telephone_number": "662-307-2750",
            "fax_number": "662-307-2438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUICK CARE CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-13",
        "last_updated": "2015-02-13",
        "status": "A",
        "authorized_official_last_name": "BLANKENSHIP",
        "authorized_official_first_name": "SALINA",
        "authorized_official_title_or_position": "CLINIC MANAGER",
        "authorized_official_telephone_number": "662-307-2750",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grenada, MS

Sources for this page

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