FAST PACE MEDICAL CLINIC PLLC
NPI 1356006712
Clinic/Center - Rural Health in Erwin, TN

Active since November 01, 2021CLIA 44D2169889 · Waiver
1112 N MAIN AVE, ERWIN, TN 37650(423) 560-6010(423) 560-6011 Get Directions Write a Review

NPPES record last updated: November 1, 2021. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Fast Pace Medical Clinic Pllc NPPES

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

FAST PACE MEDICAL CLINIC PLLC (NPI 1356006712) is a healthcare organization registered as a rural health in Erwin, Tennessee and active in the NPI registry since November 2021. The organization holds a CLIA Waiver certificate valid through July 29, 2027 and lists Robert Benson, Coo, as its authorized official.

NPPES Registry Identity

NPI1356006712
Entity TypeOrganization
Primary Taxonomy261QR1300X
Legal Business NameFAST PACE MEDICAL CLINIC PLLC
Location Address1112 N MAIN AVEErwin, TN 37650-1508
Mailing AddressPo Box 306244Nashville, TN 37230-6244
Fax(423) 560-6011
Organization SubpartNo
Authorized OfficialRobert BensonCoo · (931) 253-1110
Enumeration DateNovember 1, 2021
NPPES CertifiedNovember 1, 2021
NPI 1356006712 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyClinic/Center · Rural HealthAmbulatory Health Care Facilities
Taxonomy Code261QR1300X
1112 N MAIN AVE, Erwin, TN 37650

Other Identifiers 1

Medicaid1515574TN

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 44D2169889

Fast Pace Medical Clinic, PLLC · Erwin, TN
Active · expires Jul 29, 2027
CLIA Number44D2169889
Laboratory TypePhysician Office
Certificate Effective DateJuly 30, 2025
Certificate Expiration DateJuly 29, 2027
Laboratory DirectorSelena Gurley
Laboratory Phone(931) 253-1110
Laboratory LocationFast Pace Medical Clinic, PLLC1112 N Main Street, Erwin, TN 37650
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 2

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

Nurse Practitioner (Family)
1112 N MAIN AVE
ERWIN, TN 37650
Clinic/Center (Urgent Care)
1112 N MAIN AVE
ERWIN, TN 37650

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1356006712, enumerated as an "organization" on November 01, 2021.

The provider is located at 1112 N MAIN AVE ERWIN, TN 37650 and the phone number is (423) 560-6010.

Clinic/Center with taxonomy code 261QR1300X and a focus in Rural Health.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.