| Fast Pace Kentucky Pllc | |
|
212 S Tryon St Ste 100 Charlotte NC 28281-0033 | |
| (931) 253-1110 | |
| Not Available |
| Full Name | Fast Pace Kentucky Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 212 S Tryon St Ste 100, Charlotte, North Carolina |
| Authorized Official Name and Position | Melissa Harlan (DIRECTOR, CREDENTIALING/ENROLLMENT) |
| Authorized Official Contact | 6159489639 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Fast Pace Kentucky Pllc Po Box 306414 Nashville KY 30641 Ph: () - | Fast Pace Kentucky Pllc 212 S Tryon St Ste 100 Charlotte NC 28281-0033 Ph: (931) 253-1110 |
| NPI Number | 1609634633 |
|---|---|
| Provider Enumeration Date | 03/13/2024 |
| Last Update Date | 01/10/2025 |
| Medicare PECOS PAC ID | 0143525998 |
|---|---|
| Medicare Enrollment ID | O20240619000807 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609634633 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 261QU0200X | Clinic/center - Urgent Care | (* (Not Available)) | Primary |
| Provider Name | Powell Russ Proctor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992354310 PECOS PAC ID: 9830421197 Enrollment ID: I20191106000913 |
| Provider Name | Marie Scheller Hamrick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922732601 PECOS PAC ID: 2163806092 Enrollment ID: I20220826000895 |
| Provider Name | Trisha Ann Darling |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700548369 PECOS PAC ID: 8123483450 Enrollment ID: I20241227002169 |
| Provider Name | Heather Linton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073288320 PECOS PAC ID: 7618351438 Enrollment ID: I20250113003438 |
| Provider Name | Erica Flake |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134441587 PECOS PAC ID: 5092848770 Enrollment ID: I20250116002807 |
| Provider Name | Robert Glenn |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1902033210 PECOS PAC ID: 9335328467 Enrollment ID: I20250228001099 |
Carolina Medicorp Enterprises Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 445 South Kings Drive, Charlotte, NC 28204 Phone: 704-384-1734 Fax: 704-384-1736 | |
Novant Health Medical Group, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1900 Randolph Rd, Suite 216, Charlotte, NC 28207 Phone: 704-384-5416 Fax: 704-384-5996 | |
Carolinas Physicians Network Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 10660 Park Rd, Ste 4400, Charlotte, NC 28210 Phone: 704-355-0607 | |
Amity Medical Group, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 6010 E W T Harris Blvd, Charlotte, NC 28215 Phone: 704-208-4134 Fax: 704-248-8068 | |
Companion Health, Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5029 Lady Fern Cir, Charlotte, NC 28211 Phone: 704-236-2658 | |
Novant Health Medical Group, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 7110 Lawyers Rd, Charlotte, NC 28227 Phone: 704-537-0020 Fax: 704-316-8634 | |
Asthma & Allergy Specialists, P.a. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 8045 Providence Rd Ste 300, Charlotte, NC 28277 Phone: 704-341-9600 Fax: 704-341-9996 |