NPI age
9 years
Enumerated 2016-10-05
● Active Type 2 · Organization
Fasttrack Ic Ancillary Llc
Fasttrack Ic Ancillary Llc is 1 of 1881 specialist organizations in Georgia.
Primary specialty
Specialist
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Deraney
President
Last NPPES update
2016-10-05
Source: monthly bulk 2026-05
How this organization compares
Across 1881 active specialist providers in Georgia.
NPI age
9 years
↓ 10 yr below median
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2016 → 2026
2016-10Enumerated in NPPES
2016
2026
Where they practice
Primary practice location
1110 Hillcrest Pkwy, Unit #c
Dublin, GA 310213687
Mailing address
Po Box 4380
Alpharetta, GA 300234380
Authorized official
Jared Deraney
President
📞 8887280882
Individual providers at this organization
2 individual providers on file at this primary practice address.
- Lanie Welch, FNP-C Nurse Practitioner NPI 1205265683
- Anthony Yawn, NP Nurse Practitioner NPI 1225070261
Specialties
-
Specialist PrimaryAn individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
Practice context
Multi-provider organization. 2 individual providers on file at this primary address.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
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- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.