NPIMap

Organization Active NPI

Urgent Cares of America North Carolina Inc

Doing business as Fastmed Urgent Care of Winston-Salem Old Country Club

  • Non-Pharmacy Dispensing Site
  • Winston Salem, NC
National Provider Identifier
1437496791
Registry record updated Jan 7, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-Pharmacy Dispensing SiteTaxonomy code 332900000X
License
0010-02693 Issued in NC
Legal business name
URGENT CARES OF AMERICA NORTH CAROLINA INC
Doing business as
Fastmed Urgent Care of Winston-Salem Old Country Club
Practice address
4937 Old Country Club Road
Winston-Salem, NC 27104
Phone
(336) 546-1666
NPI assigned
Jan 7, 2013
Last updated
Jan 7, 2013By the provider in NPPES
Organization subpart
Yes
Parent organization
MEDVANTX, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 7, 2013

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

Authorized official

Name
Kenny Heine
Title
VP Ops
Phone
(858) 964-1508

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-Pharmacy Dispensing Site 332900000X 0010-02693 NC Primary

Addresses

Primary practice location

4937 Old Country Club Road
Winston-Salem, NC 27104

Mailing address

5626 Oberlin Dr
110
San Diego, CA 92121-1705

Other names 1

  • FASTMED URGENT CARE OF WINSTON-SALEM OLD COUNTRY CLUB Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Fastmed Urgent Care PC85 organizations share this tax ID, including this one
Part of
Medvantx Inc

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1357516800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1357516800000",
    "number": "1437496791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5626 OBERLIN DR",
            "address_2": "110",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921211705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4937 OLD COUNTRY CLUB ROAD",
            "city": "WINSTON-SALEM",
            "state": "NC",
            "postal_code": "27104",
            "telephone_number": "336-546-1666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "URGENT CARES OF AMERICA NORTH CAROLINA INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MEDVANTX, INC.",
        "enumeration_date": "2013-01-07",
        "last_updated": "2013-01-07",
        "status": "A",
        "authorized_official_last_name": "HEINE",
        "authorized_official_first_name": "KENNY",
        "authorized_official_title_or_position": "VP OPS",
        "authorized_official_telephone_number": "858-964-1508"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "NC",
            "license": "0010-02693",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FASTMED URGENT CARE OF WINSTON-SALEM OLD COUNTRY CLUB",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Winston Salem, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2013; 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.