NPIMap

Fast Pace Medical Clinic PLLC

Organization Active NPI Rural Health Clinic/Center · Tell City, IN

NPI 1982362299 · NPPES record last updated Nov 7, 2024

Key facts

NPI
1982362299
Entity type
Organization (NPI type 2)
Primary specialty
Rural Health Clinic/Center 261QR1300X
Legal business name
FAST PACE MEDICAL CLINIC PLLC
Practice address
211 E State Hwy 66
Tell City, IN 47586
Phone
(812) 772-4380
NPI assigned
Dec 3, 2021
Organization subpart
No

Authorized official

Name
Melissa Harlan
Title
Director Credentialing & Enrollment
Phone
(615) 948-9639

Owners & managing parties with NPI records 3

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

Other NPIs with the same Medicare PAC ID 14

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

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

Facilities with the same owner 1

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners 737

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 737

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
15D2133335Fast Pace Medical Clinic PLLC
1202 E Tipton St, Seymour, IN 47274		Certificate of waiverJul 10, 2027
15D2133342Fast Pace Medical Clinic PLLC
2418 16TH St, Bedford, IN 47421		Certificate of waiverJul 10, 2027
15D2157160Fast Pace Medical Clinic PLLC
3600 E Main St, Richmond, IN 47374		Certificate of waiverOct 30, 2026
15D2157163Fast Pace Medical Clinic PLLC
315 S Memorial Dr, New Castle, IN 47362		Certificate of waiverOct 30, 2026
15D2242556Fast Pace Medical Clinic, PLLC
2070 North State Highway 3, North Vernon, IN 47265		Certificate of waiverNov 8, 2027
15D2242828Fast Pace Medical Clinic, PLLC
211 US Highway 66 E, Tell City, IN 47586		Certificate of waiverNov 11, 2027
15D2258552Fast Pace Medical Clinic, PLLC
1778 E State Road 44, Shelbyville, IN 46176		Certificate of waiverApr 21, 2028
15D2265621Fast Pace Medical Clinic, PLLC
392 Rochester Crossing Drive, Rochester, IN 46975		Certificate of waiverJul 28, 2028
15D2269880Fast Pace Medical Clinic, PLLC
3 N Manatee Street, Brazil, IN 47834		Certificate of waiverOct 4, 2026
15D2291513Fast Pace Medical Clinic PLLC
1011 Indianapolis Road, Greencastle, IN 46135		Certificate of waiverOct 10, 2027
15D2291518Fast Pace Medical Clinic PLLC
3719 S Western Ave, Marion, IN 46953		Certificate of waiverOct 10, 2027
15D2291521Fast Pace Medical Clinic, PLLC
2701 N 6TH Street, Vincennes, IN 47591		Certificate of waiverOct 10, 2027
15D2291522Fast Pace Medical Clinic PLLC
2008 N Walnut Street, Hartford City, IN 47348		Certificate of waiverOct 10, 2027
15D2305014Fast Pace Medical Clinic PLLC
1312 E Hackberry St, Salem, IN 47167		Certificate of waiverMay 21, 2028

Medicare participation

Medicare fee-for-service enrollment
Enrolled (16 enrollments) in IN

Rural health clinic certification: CCN 153919

Legal name
FAST PACE MEDICAL CLINIC PLLC
Doing business as
FAST PACE MEDICAL CLINIC, LLC ; FAST PACE HEALTH
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Feb 11, 2022
Last certification
Feb 11, 2022
Ownership / control type
2B
Organization structure
Other · Proprietary
Incorporated
Oct 5, 2009 in TN
Enrollment address
211 US Highway 66 E
Tell City, IN 47586-2757

Rural health clinic certification: CCN 153920

Legal name
FAST PACE MEDICAL CLINIC PLLC
Doing business as
FAST PACE HEALTH
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Jun 22, 2022
Last certification
Jun 22, 2022
Ownership / control type
1B
Organization structure
Other · Proprietary
Incorporated
Oct 5, 2009 in TN
Enrollment address
2070 N State Highway 3
North Vernon, IN 47265-7117

Rural health clinic certification: CCN 153928

Legal name
FAST PACE MEDICAL CLINIC PLLC
Doing business as
FAST PACE HEALTH
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Jan 11, 2023
Last certification
Jan 11, 2023
Ownership / control type
1B
Organization structure
Other · Proprietary
Incorporated
Oct 5, 2009 in TN
Enrollment address
1778 E State Road 44
Shelbyville, IN 46176-1846

Rural health clinic certification: CCN 153937

Legal name
FAST PACE MEDICAL CLINIC PLLC
Doing business as
FAST PACE HEALTH
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Oct 17, 2023
Last certification
Oct 17, 2023
Ownership / control type
1B
Organization structure
Other · Proprietary
Incorporated
Oct 5, 2009 in TN
Enrollment address
3 N Manatee St
Brazil, IN 47834-1513

Rural health clinic certification: CCN 153931

Legal name
FAST PACE MEDICAL CLINIC PLLC
Doing business as
FAST PACE HEALTH
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Jun 14, 2023
Last certification
Jun 14, 2023
Ownership / control type
1B
Organization structure
Other · Proprietary
Incorporated
Oct 9, 2009 in TN
Enrollment address
1764 E State Road 163
Clinton, IN 47842-7327

Rural health clinic certification: CCN 153950

Legal name
FAST PACE MEDICAL CLINIC PLLC
Doing business as
FAST PACE HEALTH
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
May 6, 2024
Last certification
May 6, 2024
Ownership / control type
1B
Organization structure
Other · Proprietary
Incorporated
Oct 5, 2009 in TN
Enrollment address
3719 S Western Ave
Marion, IN 46953-4828

Rural health clinic certification: CCN 153941

Legal name
FAST PACE MEDICAL CLINIC PLLC
Doing business as
FAST PACE HEALTH
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Dec 22, 2023
Last certification
Dec 22, 2023
Ownership / control type
1B
Organization structure
LLC · Proprietary
Incorporated
Oct 5, 2009 in TN
Enrollment address
2008 N Walnut St
Hartford City, IN 47348-1364

Rural health clinic certification: CCN 153940

Legal name
FAST PACE MEDICAL CLINIC PLLC
Doing business as
FAST PACE HEALTH
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Dec 12, 2023
Last certification
Dec 12, 2023
Ownership / control type
1B
Organization structure
LLC · Proprietary
Incorporated
Oct 5, 2009 in TN
Enrollment address
1011 Indianapolis Rd
Greencastle, IN 46135-1598

Rural health clinic certification: CCN 153944

Legal name
FAST PACE MEDICAL CLINIC PLLC
Doing business as
FAST PACE HEALTH
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Dec 5, 2023
Last certification
Dec 5, 2023
Ownership / control type
1B
Organization structure
LLC · Proprietary
Incorporated
Oct 5, 2009 in TN
Enrollment address
2701 N 6TH St
Vincennes, IN 47591-3624

Rural health clinic certification: CCN 153943

Legal name
FAST PACE MEDICAL CLINIC PLLC
Doing business as
FAST PACE HEALTH
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Nov 27, 2023
Last certification
Nov 27, 2023
Ownership / control type
1B
Organization structure
Other · Proprietary
Incorporated
Oct 5, 2009 in TN
Enrollment address
811 W Main St
Peru, IN 46970-1742

Rural health clinic certification: CCN 153953

Legal name
FAST PACE MEDICAL CLINIC PLLC
Doing business as
FAST PACE HEALTH
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Aug 15, 2024
Last certification
Aug 15, 2024
Ownership / control type
1B
Organization structure
Other · Proprietary
Incorporated
Sep 10, 2009 in IN
Enrollment address
1312 E Hackberry St
Salem, IN 47167-9604

Rural health clinic certification: CCN 153929

Legal name
FAST PACE MEDICAL CLINIC PLLC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Dec 1, 2022
Last certification
Dec 1, 2022
Ownership / control type
1B
Most recent change of ownership
Mar 31, 2025 (1 total)
Organization structure
Other · Proprietary
Enrollment address
2418 16TH St
Bedford, IN 47421-3049

Rural health clinic certification: CCN 153925

Legal name
FAST PACE MEDICAL CLINIC PLLC
Doing business as
FAST PACE HEALTH
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Dec 1, 2022
Last certification
Dec 1, 2022
Ownership / control type
1B
Most recent change of ownership
Mar 31, 2025 (1 total)
Organization structure
Other · Proprietary
Enrollment address
315 S Memorial Dr
New Castle, IN 47362-4904

Rural health clinic certification: CCN 153926

Legal name
FAST PACE MEDICAL CLINIC PLLC
Doing business as
FAST PACE HEALTH
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Dec 1, 2022
Last certification
Dec 1, 2022
Ownership / control type
1B
Most recent change of ownership
Mar 31, 2025 (1 total)
Organization structure
Other · Proprietary
Enrollment address
1202 E Tipton St
Seymour, IN 47274-3540

Rural health clinic certification: CCN 153957

Legal name
FAST PACE MEDICAL CLINIC PLLC
Doing business as
FAST PACE HEALTH
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Apr 9, 2025
Last certification
Apr 9, 2025
Ownership / control type
1B
Organization structure
Other · Proprietary
Enrollment address
4152 W State Road 56
Hanover, IN 47243-9070

Rural health clinic certification: CCN 153927

Legal name
FAST PACE MEDICAL CLINIC PLLC
Doing business as
FAST PACE HEALTH
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Dec 1, 2022
Last certification
Dec 1, 2022
Ownership / control type
1B
Most recent change of ownership
Mar 31, 2025 (1 total)
Organization structure
Other · Proprietary
Enrollment address
3600 E Main St
Richmond, IN 47374-5935

All disclosed owners & managing parties 8

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

NameRoleSinceShare
Selena Michelle Gurley
Individual 		5% Or Greater Direct Ownership Interest Oct 5, 2019 33.33%
5% Or Greater Direct Ownership Interest Oct 5, 2019 34%
5% Or Greater Direct Ownership Interest
Owner		 Oct 5, 2019 33.33%
5% Or Greater Direct Ownership Interest
Owner		 Oct 5, 2009 33.33%
5% Or Greater Direct Ownership Interest
Owner		 Oct 5, 2019
5% Or Greater Direct Ownership Interest
Owner		 May 1, 2019 33%
5% Or Greater Direct Ownership Interest
Owner		 May 1, 2019 33.3%
Fpmcm, LLC
Organization · Franklin, TN
LLC 		5% Or Greater Direct Ownership Interest Oct 5, 2009 100%
Operational/Managerial Control Oct 5, 2009 100%
Sydni Clemmons
Individual 		Corporate Director
Credentialing Director		 Nov 11, 2021
W-2 Managing Employee
Credentialing Director		 Nov 11, 2021
Corporate Director
Credentialing Director		 Jun 1, 2022
W-2 Managing Employee
Credentialing Director		 Jun 1, 2022
W-2 Managing Employee Sep 2, 2022
W-2 Managing Employee
Director of Credentialing		 Oct 9, 2009
W-2 Managing Employee
Director of Credentialing		 Oct 23, 2023
W-2 Managing Employee
Director of Credentialing		 Oct 12, 2023
W-2 Managing Employee
Director of Credentialing		 Oct 30, 2023
W-2 Managing Employee
Director of Credentialing		 Oct 5, 2019
Karen Denise Daingerfield
Individual 		5% Or Greater Direct Ownership Interest Oct 5, 2019 33.33%
5% Or Greater Direct Ownership Interest Sep 2, 2022 33.33%
5% Or Greater Direct Ownership Interest
Owner		 Oct 5, 2019 33.33%
5% Or Greater Direct Ownership Interest
Owner		 Oct 5, 2009 33.33%
5% Or Greater Direct Ownership Interest
Owner		 May 1, 2019 33%
5% Or Greater Direct Ownership Interest
Owner		 May 1, 2019 33.3%
Dana Kay Martin
Individual 		5% Or Greater Direct Ownership Interest Oct 5, 2019 33.33%
5% Or Greater Direct Ownership Interest
NP/Owner		 Oct 5, 2019 33.33%
5% Or Greater Direct Ownership Interest
Owner		 Oct 5, 2019 33.33%
5% Or Greater Direct Ownership Interest
Owner		 Oct 5, 2009 33.33%
5% Or Greater Direct Ownership Interest
Owner		 May 1, 2019 33%
5% Or Greater Direct Ownership Interest
Owner		 May 1, 2019 33.3%
Melissa Harlan
Individual 		W-2 Managing Employee
Delegated Official		 Jan 1, 2024
W-2 Managing Employee
Director		 Jan 1, 2024 100%
W-2 Managing Employee
Director		 Jan 1, 2024
Christy Littlejohn
Individual 		W-2 Managing Employee
Delegated Official		 Jan 1, 2024
W-2 Managing Employee
Manager		 Jul 8, 2024
W-2 Managing Employee
Manager		 Jan 1, 2024 100%
W-2 Managing Employee
Manager		 Jan 1, 2024
Melissa Harlan
Individual 		W-2 Managing Employee
Director		 Jul 8, 2024

Change-of-ownership history

DateEventCounterparty
Mar 31, 2025 Change of Ownership
This provider was the buyer		 FC Indiana LLC
CCN 153929 · IN · NPI 1841911591
Mar 31, 2025 Change of Ownership
This provider was the buyer		 FC Indiana LLC
CCN 153925 · IN · NPI 1841911591
Mar 31, 2025 Change of Ownership
This provider was the buyer		 FC Indiana LLC
CCN 153926 · IN · NPI 1841911591
Mar 31, 2025 Change of Ownership
This provider was the buyer		 FC Indiana LLC
CCN 153927 · IN · NPI 1841911591

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20220118000657 IN Part a Provider - Rural Health Clinic 5395881841 Practice locations: Tell City, IN
O20220603000684 IN Part a Provider - Rural Health Clinic 5395881841 Practice locations: North Vernon, IN
O20220930001649 IN Part a Provider - Rural Health Clinic 5395881841 Practice locations: Shelbyville, IN
O20221115002540 IN Part a Provider - Rural Health Clinic 5395881841 Practice locations: Brazil, IN
O20221129000417 IN Part a Provider - Rural Health Clinic 5395881841 Practice locations: Clinton, IN
O20230810000474 IN Part a Provider - Rural Health Clinic 5395881841 Practice locations: Marion, IN
O20230824002445 IN Part a Provider - Rural Health Clinic 5395881841 Practice locations: Hartford City, IN
O20230824002641 IN Part a Provider - Rural Health Clinic 5395881841 Practice locations: Greencastle, IN
O20230824002775 IN Part a Provider - Rural Health Clinic 5395881841 Practice locations: Vincennes, IN
O20230830001778 IN Part a Provider - Rural Health Clinic 5395881841 Practice locations: Peru, IN
O20240423001161 IN Part a Provider - Rural Health Clinic 5395881841 Practice locations: Salem, IN
O20250130000658 IN Part a Provider - Rural Health Clinic 5395881841 Practice locations: Bedford, IN
O20250130001906 IN Part a Provider - Rural Health Clinic 5395881841 Practice locations: New Castle, IN
O20250205001517 IN Part a Provider - Rural Health Clinic 5395881841 Practice locations: Seymour, IN
O20250214000317 IN Part a Provider - Rural Health Clinic 5395881841 Practice locations: Hanover, IN
O20250219002881 IN Part a Provider - Rural Health Clinic 5395881841 Practice locations: Richmond, IN

National Provider Directory

Locations

1569 A St NE
Linton, IN 47441
Phone (812) 846-3380

293 Grand Valley Blvd
Martinsville, IN 46151
Phone (765) 516-6600

2717 W Broadway St
Princeton, IN 47670
Phone (812) 635-2036

392 Rochester Crossing Dr
Rochester, IN 46975
Phone (574) 325-5192

1312 E Hackberry St
Salem, IN 47167
Phone (812) 286-0126

Specialties & licenses

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

Addresses

Primary practice location

211 E State Hwy 66
Tell City, IN 47586

Mailing address

PO Box 306417
Nashville, TN 37230-6417

Other practice location 1

3704 N Opportunity Dr
Connersville, IN 47331-1017
Phone (765) 377-1300

Other practice location 2

1764 E State Road 163
Clinton, IN 47842-7327
Phone (765) 820-2120

Other practice location 3

1301 E National Hwy
Washington, IN 47501-4163
Phone (812) 674-5372

Other practice location 4

2701 N 6th St
Vincennes, IN 47591-3624
Phone (812) 790-2086

Other practice location 5

3 N Manatee St
Brazil, IN 47834-1513
Phone (812) 531-1127

Other practice location 6

1115 E Main St
Attica, IN 47918-1945
Phone (765) 764-0085

Other practice location 7

392 Rochester Crossing Dr
Rochester, IN 46975-7034
Phone (574) 325-5912

Other practice location 8

2717 W Broadway St
Princeton, IN 47670-9420
Phone (812) 635-2036

Other practice location 9

980 N Meridian St
Portland, IN 47371-1129
Phone (260) 703-3312

Other practice location 10

811 W Main St
Peru, IN 46970-1742
Phone (765) 470-4076

Other practice location 11

2070 N State Highway 3
North Vernon, IN 47265-7117
Phone (812) 772-4380

Other practice location 12

1778 E State Road 44
Shelbyville, IN 46176-1846
Phone (463) 235-3043

Other practice location 13

1312 E Hackberry St
Salem, IN 47167-9604
Phone (812) 286-0126

Other practice location 14

293 Grand Valley Blvd
Martinsville, IN 46151-6910
Phone (765) 516-6600

Other practice location 15

3719 S Western Ave
Marion, IN 46953-4828
Phone (765) 293-8485

Other practice location 16

3727 E Market St
Logansport, IN 46947-4589
Phone (574) 727-2114

Other practice location 17

1732 W North St
Kendallville, IN 46755-2850
Phone (260) 544-8054

Other practice location 18

1569 A St NE
Linton, IN 47441-1607
Phone (812) 846-3380

Other practice location 19

1011 Indianapolis Rd
Greencastle, IN 46135-1455
Phone (765) 630-6406

Other practice location 20

2008 N Walnut St
Hartford City, IN 47348-1364
Phone (765) 329-6662

Other providers in Tell City, IN

All providers in Tell City, IN · Rural Health Clinic/Center in Indiana

Sources for this page

Verify at the official NPI Registry.