NPIMap

Organization Active NPI

Mediq Urgent Care PC

  • Urgent Care Clinic/Center
  • Winston Salem, NC
National Provider Identifier
1801453089
Registry record updated May 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
MEDIQ URGENT CARE PC
Practice address
12201 N NC Highway 150 Ste 11
Winston Salem, NC 27127-9731
Phone
(336) 842-1142
Fax
(336) 842-1182
NPI assigned
May 23, 2019
Organization subpart
Yes
Parent organization
MEDIQ URGENT CARE PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 8, 2023

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

Authorized official

Name
Meezan Qayumi
Title
Administrative Manager
Phone
(336) 738-1691

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X Primary

Addresses

Primary practice location

12201 N NC Highway 150 Ste 11
Winston Salem, NC 27127-9731

Mailing address

12201 N NC Highway 150 Ste 11
Winston Salem, NC 27127-9731
Phone (336) 842-1142

Other names 1

  • MEDIQ Urgent Care Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210308000613 NC DME Supplier - Multi-Specialty - Physician 9133422306 Practice locations: Winston Salem, NC

Other NPIs with the same Medicare PAC ID 2

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

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
34D2160717Mediq Urgent Care12201 NC-150, Suite 11, Winston-Salem, NC 27127Certificate of waiverJan 16, 2027

National Provider Directory

National Provider Directory
Part of
Mediq Urgent Care PC

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1558569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683504000000",
    "number": "1801453089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12201 N NC HIGHWAY 150 STE 11",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271279731",
            "telephone_number": "336-842-1142",
            "fax_number": "336-842-1182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12201 N NC HIGHWAY 150 STE 11",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271279731",
            "telephone_number": "336-842-1142",
            "fax_number": "336-842-1182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDIQ URGENT CARE PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MEDIQ URGENT CARE PC",
        "enumeration_date": "2019-05-23",
        "last_updated": "2023-05-08",
        "certification_date": "2023-05-08",
        "status": "A",
        "authorized_official_last_name": "QAYUMI",
        "authorized_official_first_name": "MEEZAN",
        "authorized_official_title_or_position": "ADMINISTRATIVE MANAGER",
        "authorized_official_telephone_number": "336-738-1691"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MEDIQ Urgent Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MEDIQ Urgent Care",
            "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 May 8, 2023; 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.