NPIMap

Organization Active NPI

Quick Doc NC, PA

  • Primary Care Clinic/Center
  • Winston Salem, NC
National Provider Identifier
1659490597
Registry record updated Oct 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
40655 Issued in NC
Legal business name
QUICK DOC NC, PA
Practice address
3734 Reynolda Rd
Winston Salem, NC 27106-2240
Phone
(336) 922-1102
Fax
(336) 922-5012
NPI assigned
Mar 29, 2007
Last updated
Oct 8, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2020

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

Authorized official

Name
Henry Franklin Tripp Jr., M.D.NPI 1104829142
Title
Director
Phone
(336) 993-3146

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X 40655 NC Primary
General Practice Physician 208D00000X

Addresses

Primary practice location

3734 Reynolda Rd
Winston Salem, NC 27106-2240

Mailing address

3734 Reynolda Rd
Winston Salem, NC 27106-2240
Phone (336) 922-1102

Other identifiers 3

IdentifierTypeStateIssuer
01791OtherNCBLS
5922000MedicaidNC
40655OtherNCMEDICAL BOARD

Other names 1

  • Old Town Immediate Care, P.A. Former legal business name

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1175126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1602115200000",
    "number": "1659490597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3734 REYNOLDA RD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271062240",
            "telephone_number": "336-922-1102",
            "fax_number": "336-922-5012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3734 REYNOLDA RD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271062240",
            "telephone_number": "336-922-1102",
            "fax_number": "336-922-5012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUICK DOC NC, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-29",
        "last_updated": "2020-10-08",
        "certification_date": "2020-10-08",
        "status": "A",
        "authorized_official_last_name": "TRIPP",
        "authorized_official_first_name": "HENRY",
        "authorized_official_middle_name": "FRANKLIN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "336-993-3146",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NC",
            "license": "40655",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLS",
            "identifier": "01791",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5922000",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL BOARD",
            "identifier": "40655",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Old Town Immediate Care, P.A.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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 Oct 8, 2020; 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.