MEDICARE: FAST PACE KENTUCKY PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QR1300X	Rural Health Clinic/Center

General Provider Information

NPI Number	:	1861349532
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAST PACE KENTUCKY PLLC

Provider Business Mailing Address
First Line	:	PO BOX 306599
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37230-6599
Country	:	US
Telephone Number	:	931-253-1110
Fax Number	:

Provider Business Practice Location Address
First Line	:	202 JEFFERSON ST
Second Line	:
City	:	SANFORD
State	:	NC
Zip	:	27330-5636
Country	:	US
Telephone Number	:	919-842-5190
Fax Number	:

Authorized Official
Title or Position	:	MANAGER OF PAYER ENROLLMENT
Name	:	CHRISTY LITTLEJOHN
Credential	:
Telephone Number	:	931-253-1110

Provider Enumeration Date	:	03/12/2026
Last Update Date	:	03/12/2026

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