Individual provider Active NPI

Mitesh R Patel, RPH

  • Pharmacist
  • Jacksonville, FL
National Provider Identifier
1003135096
Registry record updated Mar 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PS37150 Issued in FL
Practice address
1301 Monument Rd Ste 22
Jacksonville, FL 32225-6462
Phone
(904) 727-3434
Fax
(904) 727-3464
NPI assigned
May 31, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 21, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 26020112A IN
Pharmacist 183500000X PS37150 FL Primary

Addresses

Primary practice location

1301 Monument Rd Ste 22
Jacksonville, FL 32225-6462

Mailing address

1301 Monument Rd Ste 22
Jacksonville, FL 32225-6462
Phone (904) 727-3434

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
PS37150FLMDPharmacist
26020112AINMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Om Shri Ganesh LLC Current Accepting new patients
Shriji Swami LLC CurrentSince Sep 24, 2023 Accepting new patients
Shriji Swami LLC CurrentSince Mar 24, 2024 Accepting new patients

Locations

1301 Monument Rd
Ste 22
Jacksonville, FL 32225
Phone (904) 727-3434

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1275264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710979200000",
    "number": "1003135096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 MONUMENT RD STE 22",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322256462",
            "telephone_number": "904-727-3434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 MONUMENT RD STE 22",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322256462",
            "telephone_number": "904-727-3434",
            "fax_number": "904-727-3464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "MITESH",
        "middle_name": "R",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-05-31",
        "last_updated": "2024-03-21",
        "certification_date": "2024-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IN",
            "license": "26020112A",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS37150",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.