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FAST PACE MISSISSIPPI, PLLC
NPI 1689331860
Clinic/Center - Rural Health in Vicksburg, MS

Active since November 22, 2021CLIA 25D2191040 · Waiver
2059 HIGHWAY 61 N, VICKSBURG, MS 39183(601) 429-1144 Get Directions Write a Review

NPPES record last updated: November 22, 2021. Verified against the NPPES registry weekly; last sync: August 02, 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 1689331860) is a healthcare organization registered as a rural health in Vicksburg, Mississippi and active in the NPI registry since November 2021. The organization holds a CLIA Waiver certificate valid through August 20, 2026 and lists Sydni Clemmons, Credentialing Manager, as its authorized official.

NPPES Registry Identity

NPI1689331860
Entity TypeOrganization
Primary Taxonomy261QR1300X
Legal Business NameFAST PACE MISSISSIPPI, PLLC
Location Address2059 HIGHWAY 61 NVicksburg, MS 39183-8227
Mailing AddressPo Box 306415Nashville, TN 37230-6415
Phone(601) 429-1144
Organization SubpartNo
Authorized OfficialSydni ClemmonsCredentialing Manager · (901) 351-1791
Enumeration DateNovember 22, 2021
NPPES CertifiedNovember 22, 2021
✔ NPI 1689331860 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Rural HealthAmbulatory Health Care Facilities
Taxonomy Code261QR1300X
2059 HIGHWAY 61 N, Vicksburg, MS 39183
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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 25D2191040

Fast Pace Mississippi, PLLC · Vicksburg, MS
Active · expires Aug 20, 2026
CLIA Number25D2191040
Laboratory TypePhysician Office
Certificate Effective DateAugust 21, 2024
Certificate Expiration DateAugust 20, 2026
Laboratory DirectorDana Martin
Laboratory Phone(601) 429-1144
Laboratory LocationFast Pace Mississippi, PLLC2059 Us 61, Vicksburg, MS 39183
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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 1689331860. 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 2059 Highway 61 N, Vicksburg, MS 39183. The listed phone number is (601) 429-1144.

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 25D2191040) is associated with this NPI, valid through August 20, 2026. 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 weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.