NPIMap

Organization Active NPI

Quick Care Med, LLC

  • General Practice Physician
  • Homosassa, FL
National Provider Identifier
1679135305
Registry record updated Jun 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
QUICK CARE MED, LLC
Practice address
3956 S Suncoast Blvd
Homosassa, FL 34448-2601
Phone
(352) 628-0911
Fax
(352) 503-9925
NPI assigned
Jul 2, 2019
Last updated
Jun 24, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
QUICK CARE MED LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 24, 2021

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

Authorized official

Name
Jeanette Smith
Title
Credentialing Manager
Phone
(352) 634-8736

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X Primary
Non-Pharmacy Dispensing Site 332900000X

Addresses

Primary practice location

3956 S Suncoast Blvd
Homosassa, FL 34448-2601

Mailing address

PO Box 2066
Lecanto, FL 34460-2066
Phone (352) 563-0931

Other identifiers 1

IdentifierTypeStateIssuer
013455100MedicaidFL

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL info@quickcaremed.com Health Information Exchange (HIE)

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120615000292 FL Part B Supplier - Clinic/Group Practice 8325202740 Receives reassigned benefits from 19 practitioners
8 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Williston, FL; Ocala, FL; Dunnellon, FL; Inverness, FL; Crystal River, FL; Chiefland, FL; Beverly Hills, FL; Homosassa, FL

Other NPIs on the same Medicare enrollment 8

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Quick Care Med LLC7 organizations share this tax ID, including this one
Part of
Quick Care Med LLC

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Locations

659 NE US Highway 19
Unit 1
Crystal River, FL 34429
Phone (352) 563-0911

11371 N Williams St
Ste 4
Dunnellon, FL 34432
Phone (352) 465-2273

Practitioners & affiliated clinicians

Practitioners 25

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.

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1562025600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1624492800000",
    "number": "1679135305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2066",
            "city": "LECANTO",
            "state": "FL",
            "postal_code": "344602066",
            "telephone_number": "352-563-0931",
            "fax_number": "352-563-0935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3956 S SUNCOAST BLVD",
            "city": "HOMOSASSA",
            "state": "FL",
            "postal_code": "344482601",
            "telephone_number": "352-628-0911",
            "fax_number": "352-503-9925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUICK CARE MED, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "QUICK CARE MED LLC",
        "enumeration_date": "2019-07-02",
        "last_updated": "2021-06-24",
        "certification_date": "2021-06-24",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "JEANETTE",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "352-634-8736"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "013455100",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "info@quickcaremed.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3956 S Suncoast Blvd",
            "city": "Homosassa",
            "state": "FL",
            "country_code": "US",
            "postal_code": "344482601",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Homosassa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.