Active NPI
Shivangi Manu Patel, PA
- Physician Assistant
- Concord, NC
National Provider Identifier
1003398397
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 0010-08313
- Practice address
- 920 Church St N
Concord, NC 28025-2927 - Phone
- (704) 403-3664
- NPI assigned
- Sep 3, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 0010-08313 | NC | Primary |
Addresses
Primary practice location
920 Church St N
Concord, NC 28025-2927
Mailing address
PO Box 19305
Charlotte, NC 28219-9305
Other practice location 1
1001 Blythe Blvd
Medical Center Plaza, Suite 200
Charlotte, NC 28203-5866
Phone (704) 381-8840
Other practice location 2
14214 Ballantyne Lake Rd
Charlotte, NC 28277-3372
Phone (704) 381-8840
Other practice location 3
2550 Court Dr
Gastonia, NC 28054-2152
Phone (704) 381-8840
Other practice location 4
1781 Tate Blvd SE
Hickory, NC 28602-4251
Phone (704) 381-8840
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1535932800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1660521600000",
"number": "1003398397",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 19305",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282199305"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "920 CHURCH ST N",
"city": "CONCORD",
"state": "NC",
"postal_code": "280252927",
"telephone_number": "704-403-3664"
}
],
"practiceLocations": [
{
"address_1": "1001 Blythe Blvd",
"address_2": "Medical Center Plaza, Suite 200",
"address_purpose": "LOCATION",
"city": "Charlotte",
"state": "NC",
"postal_code": "282035866",
"country_code": "US",
"telephone_number": "704-381-8840",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "14214 Ballantyne Lake Rd",
"address_purpose": "LOCATION",
"city": "Charlotte",
"state": "NC",
"postal_code": "282773372",
"country_code": "US",
"telephone_number": "704-381-8840",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2550 Court Dr",
"address_purpose": "LOCATION",
"city": "Gastonia",
"state": "NC",
"postal_code": "280542152",
"country_code": "US",
"telephone_number": "704-381-8840",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1781 Tate Blvd SE",
"address_purpose": "LOCATION",
"city": "Hickory",
"state": "NC",
"postal_code": "286024251",
"country_code": "US",
"telephone_number": "704-381-8840",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PATEL",
"first_name": "SHIVANGI",
"middle_name": "MANU",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-09-03",
"last_updated": "2022-08-15",
"certification_date": "2022-08-15",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NC",
"license": "0010-08313",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Concord, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.