NPIMap

Organization Active NPI

Fast Track Urgent Care, LLC

  • Primary Care Clinic/Center
  • Eldersburg, MD
National Provider Identifier
1982011821
Registry record updated Jul 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
C0004696 Issued in MD
Legal business name
FAST TRACK URGENT CARE, LLC
Practice address
1315 Breton Drive
Eldersburg, MD 21784
Phone
(443) 518-6574
Fax
(866) 596-1084
NPI assigned
Jul 11, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2014

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

Authorized official

Name
Mr. Olayinka Olasimbo, PHYSICIAN ASSISTANT
Title
President / Owner
Phone
(443) 518-6574

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X C0004696 MD Primary

Addresses

Primary practice location

1315 Breton Drive
Eldersburg, MD 21784

Mailing address

1315 Breton Dr
Eldersburg, MD 21784-6137
Phone (443) 518-6574

Other identifiers 1

IdentifierTypeStateIssuer
C0004696OtherMDPA LICENSE

National Provider Directory

National Provider Directory
Tax ID family
Fast Track Urgent Care LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

NPI Registry JSON

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

{
    "created_epoch": "1405036800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1405036800000",
    "number": "1982011821",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1315 BRETON DR",
            "city": "ELDERSBURG",
            "state": "MD",
            "postal_code": "217846137",
            "telephone_number": "443-518-6574",
            "fax_number": "866-596-1084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1315 BRETON DRIVE",
            "city": "ELDERSBURG",
            "state": "MD",
            "postal_code": "21784",
            "telephone_number": "443-518-6574",
            "fax_number": "866-596-1084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAST TRACK URGENT CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-11",
        "last_updated": "2014-07-11",
        "status": "A",
        "authorized_official_last_name": "OLASIMBO",
        "authorized_official_first_name": "OLAYINKA",
        "authorized_official_title_or_position": "PRESIDENT / OWNER",
        "authorized_official_telephone_number": "443-518-6574",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PHYSICIAN ASSISTANT"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "MD",
            "license": "C0004696",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA LICENSE",
            "identifier": "C0004696",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Eldersburg, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.