FAST PACE MISSISSIPPI, PLLC
NPI 1013674373
Clinic/Center - Rural Health in Clarksdale, MS

Active since November 22, 2021CLIA 25D2150750 · Waiver
619 S STATE ST, CLARKSDALE, MS 38614(662) 966-1012 Get Directions Write a Review

NPPES record last updated: November 22, 2021. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Fast Pace Mississippi, Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

FAST PACE MISSISSIPPI, PLLC (NPI 1013674373) is a healthcare organization registered as a rural health in Clarksdale, Mississippi and active in the NPI registry since November 2021. The organization holds a CLIA Waiver certificate valid through July 1, 2028 and lists Sydni Clemmons, Credentialing Manager, as its authorized official.

NPPES Registry Identity

NPI1013674373
Entity TypeOrganization
Primary Taxonomy261QR1300X
Legal Business NameFAST PACE MISSISSIPPI, PLLC
Location Address619 S STATE STClarksdale, MS 38614-6319
Mailing AddressPo Box 306415Nashville, TN 37230-6415
Organization SubpartNo
Authorized OfficialSydni ClemmonsCredentialing Manager · (901) 351-1791
Enumeration DateNovember 22, 2021
NPPES CertifiedNovember 22, 2021
NPI 1013674373 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyClinic/Center · Rural HealthAmbulatory Health Care Facilities
Taxonomy Code261QR1300X
619 S STATE ST, Clarksdale, MS 38614

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 25D2150750

Fast Pace Mississippi, PLLC · Clarksdale, MS
Active · expires Jul 1, 2028
CLIA Number25D2150750
Laboratory TypePhysician Office
Certificate Effective DateJuly 2, 2026
Certificate Expiration DateJuly 1, 2028
Laboratory DirectorDana Martin
Laboratory Phone(662) 966-1012
Laboratory LocationFast Pace Mississippi, PLLC619 S State Street, Clarksdale, MS 38614
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Nurse Practitioner
619 S STATE ST
CLARKSDALE, MS 38614
Nurse Practitioner (Family)
619 S STATE ST
CLARKSDALE, MS 38614
Nurse Practitioner (Family)
619 S STATE ST
CLARKSDALE, MS 38614
Nurse Practitioner (Family)
619 S STATE ST
CLARKSDALE, MS 38614
Nurse Practitioner (Family)
619 S STATE ST
CLARKSDALE, MS 38614

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Fast Pace Mississippi, PLLC's NPI number?

The NPI number for Fast Pace Mississippi, PLLC is 1013674373. It was assigned to this organization in the NPPES registry on November 22, 2021.

Where is Fast Pace Mississippi, PLLC located?

Fast Pace Mississippi, PLLC is located at 619 S State St, Clarksdale, MS 38614. The listed phone number is (662) 966-1012.

What is Fast Pace Mississippi, PLLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Rural Health, with taxonomy code 261QR1300X.

Does Fast Pace Mississippi, PLLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 25D2150750) is associated with this NPI, valid through July 1, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Fast Pace Mississippi, PLLC was last updated on November 22, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.