Active NPI
Quick Care Med, LLC
- General Practice Physician
- Williston, FL
National Provider Identifier
1962060939
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- 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
- Last updated
- Jun 24, 2021
- Organization subpart
- Yes
- Parent organization
- QUICK CARE MED LLC
NPPES NPI Registry
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) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | Primary | ||
| 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 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 003672406 | Medicaid | FL |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | info@quickcaremed.com | ||
| 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 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 |
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- Part of
- Quick Care Med
Interoperability endpoints
- info@quickcaremed.com
Practitioners & affiliated clinicians
Practitioners 4
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.
-
- Family Nurse Practitioner
- Crystal River, FL
- NPI 1194159301
-
- Family Nurse Practitioner
- Beverly Hills, FL
- NPI 1134810740
-
- Family Nurse Practitioner
- West Palm Beach, FL
- NPI 1053001917
-
- Family Nurse Practitioner
- Inverness, FL
- NPI 1689385163
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1559606400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1624492800000",
"number": "1962060939",
"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": "517 W NOBLE AVE",
"city": "WILLISTON",
"state": "FL",
"postal_code": "32696",
"telephone_number": "352-528-9355",
"fax_number": "352-528-7427"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "QUICK CARE MED, LLC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "QUICK CARE MED LLC",
"enumeration_date": "2019-06-04",
"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": "003672406",
"state": "FL"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "info@quickcaremed.com",
"affiliation": "N",
"address_1": "517 W Noble Ave",
"city": "Williston",
"state": "FL",
"country_code": "US",
"postal_code": "32696",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "info@quickcaremed.com",
"affiliation": "N",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "517 W Noble Ave",
"city": "Williston",
"state": "FL",
"country_code": "US",
"postal_code": "32696",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Williston, FL
- Candace Penny, FNP-BC
- Patricia Ann Perkins, PT
- Phi 413, Inc Dba Good Samaritan Retirement Home
- Pry Inc (Good Samaritan Retirement Home)
- Quality Care Transport Solutions
- James Lee Quinlan, DNP, ARNP
- Jacqueline Lewis Ramirez, FNP-C
- Kolli Prabhakara Reddy, MD
- Regional Health Partners LLC (Regional General Hospital)
- Regional Health Partners LLC (Regional General Hospital)
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.