Provider Demographics
NPI:1063619997
Name:FAST ACCESS HEALTHCARE
Entity type:Organization
Organization Name:FAST ACCESS HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:M
Authorized Official - Last Name:KERLEY
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:423-894-0432
Mailing Address - Street 1:PO BOX 23367
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37422-3367
Mailing Address - Country:US
Mailing Address - Phone:423-456-7001
Mailing Address - Fax:888-356-3103
Practice Address - Street 1:2372 LIFESTYLE WAY STE 152
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-4940
Practice Address - Country:US
Practice Address - Phone:423-894-0432
Practice Address - Fax:423-894-0475
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-03
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty
No207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3370172Medicaid
TN3370172OtherMEDICARE PTAN
TN3370172Medicare PIN