NPIMap

Organization Active NPI

Fast Pace Medical Clinic PLLC

  • Rural Health Clinic/Center
  • Scottsboro, AL
National Provider Identifier
1770397127
Registry record updated Feb 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
FAST PACE MEDICAL CLINIC PLLC
Practice address
324 Micah Way
Scottsboro, AL 35769
Phone
(931) 253-1110
NPI assigned
Feb 5, 2025
Last updated
Feb 5, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2025

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

Authorized official

Name
Kimberly M Frazier
Title
Group Enrollment Supervisor
Phone
(803) 804-2043

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X NU Primary

Addresses

Primary practice location

324 Micah Way
Scottsboro, AL 35769

Mailing address

PO Box 681029
Franklin, TN 37068-1029
Phone (931) 253-1110

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250307001270 AL Part A Provider - Rural Health Clinic 5395881841 Practice locations: Scottsboro, AL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1770397127. Details of each certification follow.

Rural health clinic certification: CCN 018987

Legal name
FAST PACE MEDICAL CLINIC PLLC
Doing business as
FAST PACE HEALTH
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Jul 1, 2025
Last certification
Jul 1, 2025
Ownership / control type
1B
Organization structure
OtherProprietary
Enrollment address
324 Micah Way
Scottsboro, AL 35769-4164

Other NPIs with the same Medicare PAC ID 14

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 14

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
01D2314458Fast Pace Medical Clinic PLLC324 Micah Way, Scottsboro, AL 35769Certificate of waiverNov 19, 2026

National Provider Directory

National Provider Directory
Tax ID family
Fast Pace Medical Clinic PLLC133 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 6

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

Ownership & related parties

All disclosed owners & managing parties 5

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Melissa Harlan Individual W-2 Managing EmployeeDelegated Official Jan 1, 2024
Selena Michelle Gurley Individual 5% Or Greater Direct Ownership InterestOwner Oct 5, 2019 33.33%
Christy Littlejohn Individual W-2 Managing EmployeeDelegated Official Jan 1, 2024
Karen Denise Daingerfield Individual 5% Or Greater Direct Ownership InterestOwner Oct 5, 2019 33.33%
Dana Kay Martin Individual 5% Or Greater Direct Ownership InterestOwner Oct 5, 2019 33.33%

Owners & managing parties with NPI records 3

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

NPI Registry JSON

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

{
    "created_epoch": "1738713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738713600000",
    "number": "1770397127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 681029",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "370681029",
            "telephone_number": "931-253-1110",
            "fax_number": "931-722-9919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "324 MICAH WAY",
            "city": "SCOTTSBORO",
            "state": "AL",
            "postal_code": "35769",
            "telephone_number": "931-253-1110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAST PACE MEDICAL CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-05",
        "last_updated": "2025-02-05",
        "certification_date": "2025-02-03",
        "status": "A",
        "authorized_official_last_name": "FRAZIER",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "GROUP ENROLLMENT SUPERVISOR",
        "authorized_official_telephone_number": "803-804-2043"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsboro, AL

Sources for this page

Verify at the official NPI Registry.