Quick Care Med, LLC
Organization Active NPI General Practice Physician · Williston, FL
NPI 1962060939 · NPPES record last updated Jun 24, 2021
Key facts
- NPI
- 1962060939
- Entity type
- Organization (NPI type 2)
- Primary specialty
- General Practice Physician 208D00000X
- Legal business name
- QUICK CARE MED, LLC
- Practice address
- 517 W Noble Ave
Williston, FL 32696 - Phone
- (352) 528-9355
- Fax
- (352) 528-7427
- NPI assigned
- Jun 4, 2019
- Organization subpart
- Yes
- Parent organization (as reported)
- QUICK CARE MED LLC
Authorized official
- Name
- Jeanette Smith
- Title
- Credentialing Manager
- Phone
- (352) 634-8736
Other NPIs on the same Medicare enrollment 8
Practitioners 4
-
Mary Ann Ferguson, ARNP
-
Heather Marie Holmes, APRN, FNP-BC
-
Rosanna Diane Zsomboran, APRN
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 |
National Provider Directory
- Part of
- Quick Care Med LLC
Locations
517 W Noble Ave
Williston, FL 32696
Phone (352) 528-9355
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician |
208D00000X | Yes | ||
| Non-Pharmacy Dispensing Site | 332900000X |
Addresses
Primary practice location
517 W Noble Ave
Williston, FL 32696
Mailing address
PO Box 2066
Lecanto, FL 34460-2066
Phone (352) 563-0931
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 003672406 | Medicaid | FL |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | info@quickcaremed.com | ||
| Other URL | info@quickcaremed.com | Health Information Exchange (HIE) |
Other providers in Williston, FL
- Candace Penny
- Patricia Ann Perkins
- Phi 413, Inc Dba Good Samaritan Retirement Home
- Pry Inc
- Quality Care Transport Solutions
- James Lee Quinlan
- Jacqueline Lewis Ramirez
- Kolli Prabhakara Reddy
- Regional Health Partners LLC
- Regional Health Partners LLC
All providers in Williston, FL · General Practice Physician in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 24, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.